Healthcare Provider Details

I. General information

NPI: 1215327770
Provider Name (Legal Business Name): NICHOLE SUSANE LANIER LMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICHOLE SUSANE TORRES LMHC

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2483 TRENT DR
MARIETTA GA
30066-5731
US

IV. Provider business mailing address

2483 TRENT DR
MARIETTA GA
30066-5731
US

V. Phone/Fax

Practice location:
  • Phone: 407-608-9064
  • Fax:
Mailing address:
  • Phone: 407-608-9064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH16203
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC011761
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: