Nicole Regina Phifer, MA,ST, BA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1903 Phoenix Blvd
College Park, GA 30349-5754

Phone

(678) 335-9010

NPI assigned

May 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts, Master of Arts

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1750903761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 OLD FARM RD",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303494259",
            "telephone_number": "678-254-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 PHOENIX BLVD",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495754",
            "telephone_number": "678-335-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIFER",
        "first_name": "NICOLE",
        "middle_name": "REGINA",
        "credential": "MA,ST, BA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Atlanta",
            "affiliation": "N",
            "address_1": "1903 Phoenix Blvd",
            "city": "College Park",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303495754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Phenix Community Care Group, LLC
• Phoenix Medical Office at College Park,LLC
• Phoenix Women's Center, P.C.
• Physiotherapy Associates Inc (Physio-College Park)
• Gabrielle Pointer
• Polaris Spine & Neurosurgery Center PC

• Mental Health Counselor in College Park, GA
• Providers in College Park, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.