Individual
GLENN ANTHONY NILES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4039 GATEWAY BLVD, GROVETOWN, GA 30813-3389
(706) 498-9570
(678) 369-5762
Mailing address
4039 GATEWAY BLVD, GROVETOWN, GA 30813-3389
(706) 498-9570
(678) 369-5762
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC009918
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
10/26/2017
Last updated
02/20/2026
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