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NPI Code Detail

MEDICARE: PRACTICAL BEHAVIORAL CARE LLC

MEDICARE: PRACTICAL BEHAVIORAL CARE LLC
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
1363LF0000XFamily Nurse Practitioner
2363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1790648632
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRACTICAL BEHAVIORAL CARE LLC
Provider Business Mailing Address
First Line : 1201 W PEACHTREE ST NW STE 2300
Second Line :
City : ATLANTA
State : GA
Zip : 30309-3453
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1201 W PEACHTREE ST NW STE 2300
Second Line :
City : ATLANTA
State : GA
Zip : 30309-3453
Country : US
Telephone Number : 678-765-9900
Fax Number :
Authorized Official
Title or Position : NURSE PRACTITIONER
Name : NYCOLE ASHLEY COX
Credential : NP-C
Telephone Number : 330-998-8033
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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Directions to “PRACTICAL BEHAVIORAL CARE LLC ” Practice Location

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