Individual provider · Type 1 NPI

Ebony Nicole Derrickson, MS DDP

Mental Health Counselor · Loganville, GA

NPI number 1881336907 Active

Practice location

125 Lee Byrd Rd
Loganville, GA 30052-2310

Call (678) 883-8609 Map

Mailing address

750 Gaines School Rd Apt I156
Athens, GA 30605-3254

Other practice locations

  • 2795 Main St W, Snellville, GA 30078-3164 · (678) 334-7836

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Counseling Psychologist 103TC1900XNone listed
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

5 other providers at this address

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About NPI 1881336907

Ebony Nicole Derrickson, MS DDP's National Provider Identifier is 1881336907, issued on Apr 9, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Loganville, GA. The record was last updated on Apr 9, 2022.