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General NPI Number Information
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NPI Number | 1790299881
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Entity Type | Individual
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Provider Name | NICOLE WALKER WOOD M.A., LPC, NCC, CPCS
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Gender | Female
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 255 VILLAGE PKWY NE STE 580
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City | MARIETTA
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State | GA
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Zip | 30067-4161
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Country | US
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Telephone | 770-726-9589
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Fax |
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Provider Business Mailing Address
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Address Line | 251 RIVER PARK NORTH DR
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City | WOODSTOCK
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State | GA
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Zip | 30188-7835
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Country | US
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Telephone | 678-539-0281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC008388
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License Number State | GA
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