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NPI Code Detail

MEDICARE: NICHOLAS JUWAN RICHARDS

MEDICARE: NICHOLAS JUWAN RICHARDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1023849478
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS JUWAN RICHARDS
Provider Business Mailing Address
First Line : 1872 CLAY DR SW
Second Line :
City : MARIETTA
State : GA
Zip : 30064-6000
Country : US
Telephone Number : 404-996-9961
Fax Number :
Provider Business Practice Location Address
First Line : 2440 SANDY PLAINS RD BLDG 25
Second Line :
City : MARIETTA
State : GA
Zip : 30066-7232
Country : US
Telephone Number : 770-971-9311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2024
Last Update Date : 09/03/2024

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Directions to “ NICHOLAS JUWAN RICHARDS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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