Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edie Nicholson, PCMHT

Individual provider Counselor · NPI 1295507879

Edie Nicholson, PCMHT is a Counselor in Ellisville, Mississippi. Licensed in Mississippi. Registered with an NPI since 2023.

Licensed in
MS
In the registry since
2023

Practice location Address checks out

5192 Highway 11 N
Ellisville, MS 39437-5050
Phone: (601) 649-7921
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence 6059 (MS)

Record details

NPI number1295507879
Entity typeIndividual (Type 1)
GenderFemale
Credentials PCMHT
Sole proprietorNo
NPI enumeratedOctober 26, 2023
Last updated in NPPESOctober 26, 2023
Certification dateOctober 26, 2023
Mailing addressPo Box 18679, Hattiesburg, MS 39404-8679

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