AMBER BLAINE NICHOLSON NPI 1609790013

NPI Information

NPI: 1609790013
Provider Name: AMBER BLAINE NICHOLSON
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Individual
Address: 309 MATTHEWS AVE
CARROLLTON, GA
ZIP 30117
Phone: (561) 914-7155

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NPI Details

Amber Blaine Nicholson is a community based residential treatment facility mental illness in Carrollton, GA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. Amber Blaine Nicholson NPI is 1609790013. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

309 MATTHEWS AVE
CARROLLTON, GA
ZIP 30117-629
Phone: (561) 914-7155

The enumeration date for this NPI number is 8/7/2026 and was last updated on 8/7/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	No
2	323P00000X	Psychiatric Residential Treatment Facility	No
3	324500000X	Substance Abuse Rehabilitation Facility	No
4	385H00000X	Respite Care	No
5	320800000X	Community Based Residential Treatment Facility, Mental Illness	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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