Individual provider · Type 1 NPI

Edie Nicholson, PCMHT

Counselor · Ellisville, MS

NPI number 1295507879 Active

Practice location

5192 Highway 11 N
Ellisville, MS 39437-5050

Call (601) 649-7921 Map

Mailing address

PO Box 18679
Hattiesburg, MS 39404-8679

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000X6059 (MS)

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1295507879

Edie Nicholson, PCMHT's National Provider Identifier is 1295507879, issued on Oct 26, 2023. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Ellisville, MS. The record was last updated on Oct 26, 2023.