Individual provider Active NPI

Nikisha Moet Douge, LMFT

  • Marriage & Family Therapist
  • Atlanta, GA
National Provider Identifier
1194392738
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT002212 Issued in GA
Practice address
3330 Cumberland Blvd SE
Atlanta, GA 30339-5995
Phone
(404) 939-1989
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT002212 GA Primary
Marriage & Family Therapist 106H00000X T3316 OR

Addresses

Primary practice location

3330 Cumberland Blvd SE
Atlanta, GA 30339-5995

Mailing address

8735 Dunwoody PL Ste R
Atlanta, GA 30350-2995
Phone (404) 939-1989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251024001917 OR Practitioner - Marriage and Family Therapist 7012405517 Reassigns benefits to 1 organization
I20260107001832 GA Practitioner - Marriage and Family Therapist 7012405517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1618 Chancery LN
Lithia Springs, GA 30122-3823

6505 216TH St SW
Suite 100
Mountlake Terrace, WA 98043-2089

8735 Dunwoody PL
Atlanta, GA 30350-2995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT002212GAMDMarriage & Family Therapist
T3316ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heartwood Marriage & Family Wellness LLC Marriage & Family Therapist CurrentSince Aug 11, 2025 Accepting new patients
Mindful Therapy Group PC Marriage & Family Therapist CurrentSince Oct 9, 2025 Accepting new patients

Locations

3330 Cumberland Blvd SE
Atlanta, GA 30339
Phone (404) 939-1989

3330 Cumberland Blvd SE
Ste 500
Atlanta, GA 30339
Phone (404) 726-0283

8735 Dunwoody Pl
Ste R
Sandy Springs, GA 30350
Phone (478) 298-6924

5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100

11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1194392738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8735 DUNWOODY PL STE R",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502995",
            "telephone_number": "404-939-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 CUMBERLAND BLVD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395995",
            "telephone_number": "404-939-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGE",
        "first_name": "NIKISHA",
        "middle_name": "MOET",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT002212",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T3316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.