Individual
MS. NICOLE STACEY FORGOSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1100 LAKE HEARN DRIVE, NE STE'S 250 & 500, KAISER PERMANENTE SANDY SPRINGS MEDICAL CENTER, SANDY SPRINGS, GA 30342
(404) 845-4500
(212) 584-5450
Mailing address
3495 PIEDMONT ROAD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305
(404) 364-7070
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
081844
NY
104100000X
Social Worker
Primary
CSW005015
GA
Other
Enumeration date
11/30/2010
Last updated
04/13/2022
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