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

MS. Ebony Nicole Derrickson, MSDDP

Individual provider Counselor · NPI 1881336907

MS. Ebony Nicole Derrickson, MSDDP is a Counselor in Loganville, Georgia. Practices as a sole proprietor and works from 2 locations. Licensed in Georgia.

Licensed in
GA
In the registry since
2022
Specialties on file
3

Practice location Address checks out

125 Lee Byrd Rd
Loganville, GA 30052-2310
Phone: (678) 883-8609
Show map & directions

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

Additional practice locations (1)

  • 2795 Main St W, Snellville, GA 30078-3164 — (678) 334-7836

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X (GA)
Counselor Taxonomy 101Y00000X
Counseling Psychologist Taxonomy 103TC1900X

Record details

NPI number1881336907
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSDDP
Sole proprietorYes
NPI enumeratedApril 9, 2022
Last updated in NPPESApril 9, 2022
Certification dateApril 9, 2022

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