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Organization

SILVER CYPRESS GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE YAKSH LPC, NCC, CCTP (FOUNDER, CLINICAL DIRECTOR)
(770) 823-2636
Entity
Organization

Contact information

Practice address
515 WOODWARD DR, FAYETTEVILLE, GA 30215-7641
(770) 823-2636
Mailing address
515 WOODWARD DR, FAYETTEVILLE, GA 30215-7641
(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
11/15/2022
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