| Nicole Tholmer, Lpc Llc | |
| 
					112 Cumberland Gate Se Smyrna GA 30080-7705  | |
| (770) 765-1652 | |
| (678) 426-8464 | 
| Full Name | Nicole Tholmer, Lpc Llc | 
|---|---|
| Speciality | Clinic/center - Adult Mental Health | 
| Location | 112 Cumberland Gate Se, Smyrna, Georgia | 
| Authorized Official Name and Position | Nicole Tholmer (CEO/ THERAPIST) | 
| Authorized Official Contact | 7707651652 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Nicole Tholmer, Lpc Llc 3316a S Cobb Dr Se Ste 221 Smyrna GA 30080-4118 Ph: (770) 765-1652  | Nicole Tholmer, Lpc Llc 112 Cumberland Gate Se Smyrna GA 30080-7705 Ph: (770) 765-1652  | 
| NPI Number | 1477263200 | 
|---|---|
| Provider Enumeration Date | 12/02/2022 | 
| Last Update Date | 02/05/2024 | 
| Certification Date | 02/05/2024 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1477263200 | NPI | - | NPPES | 
| 003204125A | Medicaid | GA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary | 
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