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NPI Code Detail

MEDICARE: DR. NETTIE FAYE CULVER PH.D.

MEDICARE:  DR. NETTIE FAYE CULVER  PH.D.
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCE# 1687GA
2101YP2500XProfessional CounselorLPC002094GA

General Provider Information

NPI Number : 1346631967
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NETTIE FAYE CULVER PH.D.
Provider Business Mailing Address
First Line : PO BOX 121
Second Line :
City : AUSTELL
State : GA
Zip : 30168-1002
Country : US
Telephone Number : 678-499-4235
Fax Number :
Provider Business Practice Location Address
First Line : 2245 GODBY RD
Second Line : SUITE 102/104
City : COLLEGE PARK
State : GA
Zip : 30349-5059
Country : US
Telephone Number : 404-761-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2015
Last Update Date : 02/18/2015

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Directions to “ DR. NETTIE FAYE CULVER PH.D.” Practice Location

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