Individual
MS. EBONY NICOLE DERRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS DDP
Contact information
Practice address
125 LEE BYRD RD, LOGANVILLE, GA 30052-2310
(678) 883-8609
Mailing address
750 GAINES SCHOOL RD APT I156, ATHENS, GA 30605-3254
(706) 296-4666
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
GA
103TC1900X
Counseling Psychologist
—
—
Other
Enumeration date
04/09/2022
Last updated
04/09/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us