NICKOLE BUSH (NPI# 1366088379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366088379 |
| Entity Type | Individual |
| Full Name | NICKOLE BUSH |
| Practice Address |
101 Quartz Dr Ste 103a Villa Rica GA 30180-3201 |
| Practice Telephone | 6784716925 |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
APC006745 | GA | Behavioral Health & Social Service Providers |
| Street Address |
101 QUARTZ DR STE 103A |
| City | VILLA RICA |
| State | GA |
| Zip Code | 30180-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033441290 | Tanner Medical Center, Inc. | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3256 | 2010-02-12 |
| 1023629300 | Lisa Junger | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3201 | 2020-08-11 |
| 1346861515 | Erin Durham | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3201 | 2020-04-29 |
| 1124664941 | Brittany Lilly | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3201 | 2019-11-27 |
| 1457911067 | Syreeta Renee Nalls | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3201 | 2019-06-17 |
| 1043775810 | Tiffani Venigee Fryar | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3201 | 2019-02-06 |
| 1972015394 | Kesha Greene | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3201 | 2017-10-25 |
| 1811408628 | Ashley Majesta Magistro | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3201 | 2017-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174161624 | Crucible Communication Therapy LLC | Speech-Language Pathologist | 9765 Walnut Grove Trail, Villa Rica, GA 30180 | 2019-12-16 |
| 1366802845 | Medic-pearl, LLC | Ambulance | 1108 Charter Oak Ct, Villa Rica, GA 30180 | 2016-02-26 |
| 1396138368 | Josette Etienne | Nurse Practitioner | 403 Permian Way Suite A, Villa Rica, GA 30180 | 2015-03-13 |
| 1447690516 | Judith L.m. Thigpen | Nurse Practitioner | 736 Highway 78 West, Minute Clinic, Villa Rica, GA 30180 | 2013-07-03 |
| 1477890168 | Wesley Douglas Mckenzie | Pharmacist | 2500 Mirror Lake Blvd, Villa Rica, GA 30180 | 2013-01-15 |
| 1497005359 | Malika Remie Rajendra | Optometrist | 600 Hwy 61, Villa Rica, GA 30180 | 2012-09-18 |
| 1972876449 | Catherine Elaine Tyson | Pharmacist | 601 Dallas Road, Villa Rica, GA 30180 | 2012-02-14 |
| 1619262433 | Villa Rica Rx LLC | Pharmacy | 222 West Wilson Street, Villa Rica, GA 30180 | 2011-06-09 |
| 1851602874 | Jules Chopin Sybert | Nurse Practitioner | 736 W. Bankhead Hwy, Villa Rica, GA 30180 | 2010-06-24 |
| 1487984019 | Lisa Wood | Occupational Therapy Assistant | 1207 Woods Walk, Villa Rica, GA 30180 | 2010-01-04 |
| Find all providers in zip 30180 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679969018 | Aleta Dobbs-farmer | Counselor | 9090 Tarnwood Dr, Villa Rica, GA 30180-7675 | 2015-04-13 |
| 1992140057 | Danielle Tolbert | Counselor | 611 North Ave, Villa Rica, GA 30180-1206 | 2013-05-02 |
| 1346861515 | Erin Durham | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3201 | 2020-04-29 |
| 1386276483 | Chelsesa Arissa Pounds | Counselor | 20 Herrell Rd, Villa Rica, GA 30180-5527 | 2020-02-06 |
| 1417594938 | Anna Cowan | Counselor | 101 Quartz Dr, Villa Rica, GA 30180-3255 | 2019-12-03 |
| 1013554534 | Allyson Moffatt | Counselor | 20 Herrell Rd, Villa Rica, GA 30180-5527 | 2019-12-03 |
| 1851937726 | El Janeo D Vereen | Counselor | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2019-11-25 |
| 1285080051 | Chasity Phillips | Counselor | 514 W Bankhead Hwy Ste 100, Villa Rica, GA 30180-1737 | 2016-05-10 |
| 1902271240 | Lauren Hester | Counselor | 611 North Ave, Villa Rica, GA 30180-1206 | 2015-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780859 | Jennifer Lynn Fedderick | Counselor | 459 Thrasher Rd, Plains, GA 31780-5310 | 2020-11-04 |
| 1376144766 | Arlicia Lagene Johnson | Counselor | 220 Osmanthus Way, Canton, GA 30114-7197 | 2020-11-03 |
| 1558962027 | Evan Kauper | Counselor | 2002 Smith Dr Nw, Kennesaw, GA 30144-1851 | 2020-11-02 |
| 1801496864 | Poonam A Patel | Counselor | 2916 Clairmont Rd Ne Apt 2413, Brookhaven, GA 30329-4476 | 2020-10-29 |
| 1740880061 | Pledger Behavior Consulting, LLC | Counselor | 7563 Highway 337, Summerville, GA 30747-6101 | 2020-10-27 |
| 1801495411 | Bianca Tiara Abrams | Counselor | 916 Glenwood Park Dr Se, Atlanta, GA 30316-6845 | 2020-10-23 |
| 1780283713 | Stacey Dougan | Counselor | 696 Mountain Dr Ne, Atlanta, GA 30342-3904 | 2020-10-21 |
| 1619576865 | Therapy Pond, LLC | Counselor | 1262 Concord Rd Se Ste 200, Smyrna, GA 30080-5307 | 2020-10-20 |
| 1164021259 | Miracles Outreach International | Counselor | 6825 Jimmy Carter Blvd Ste 1570b, Norcross, GA 30071-1215 | 2020-10-20 |
| 1699374025 | Alexxis Trimmings | Counselor | 205 W Montgomery Xrd Apt 106, Savannah, GA 31406-7121 | 2020-10-17 |
| Find all providers with the same taxonomy | ||||
| City | VILLA RICA |
| Zip Code | 30180 |
Please comment or provide details below to improve the information on NICKOLE BUSH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.