Individual
NICOLE CHACIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
271B S CULVER ST, LAWRENCEVILLE, GA 30046-4805
(678) 824-5899
Mailing address
271B S CULVER ST, LAWRENCEVILLE, GA 30046-4805
(678) 824-5899
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
008888
GA
103TC1900X
Counseling Psychologist
Primary
008888
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003178904A
—
GA
Enumeration date
10/28/2008
Last updated
12/10/2024
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