Organization
SILVER CYPRESS GROUP, LLC
Active
Organization
SILVER CYPRESS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE RAINE LPC, NCC, CCTP (FOUNDER, CLINICAL DIRECTOR)
(770) 823-2636
Entity
Organization
Contact information
Practice address
480 WOODWARD DR, FAYETTEVILLE, GA 30215-7638
(770) 823-2636
Mailing address
480 WOODWARD DR, FAYETTEVILLE, GA 30215-7638
(770) 823-2636
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/15/2022
Last updated
08/12/2026
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