Healthcare Provider Details

I. General information

NPI: 1689759706
Provider Name (Legal Business Name): NICOLE ALDRED LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 CENTERVIEW DR SUITE 300
BRENTWOOD TN
37027-5246
US

IV. Provider business mailing address

1830 WATER PL SE SUITE 200
ATLANTA GA
30339-7407
US

V. Phone/Fax

Practice location:
  • Phone: 615-370-4228
  • Fax: 615-370-4220
Mailing address:
  • Phone: 770-916-9031
  • Fax: 770-916-9030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT1066
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: