DR. ANASTACIA A. NICHOLS PSYD
NPI 1174185763
Psychologist - Clinical in Atlanta, GA

Active since July 03, 2019PECOS EnrolledAccepts Medicare Assignment
92.26/100
CMS Quality Rating
12 EXECUTIVE PARK DR NE, ATLANTA, GA 30329(404) 712-5667 Get Directions Write a Review

NPPES record last updated: January 20, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 20, 2026, Aug 5, 2019, Jul 3, 2019 (3 updates tracked since 2019).

About Dr. Anastacia A. Nichols Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ANASTACIA A. NICHOLS PSYD (NPI 1174185763) is an individual clinical provider in Atlanta, Georgia, licensed in Georgia (PSY004308) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Atlanta, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1174185763
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. ANASTACIA A. NICHOLSCredential: PSYD
Location Address12 EXECUTIVE PARK DR NEAtlanta, GA 30329-2206
Mailing Address1441 Clifton Rd Ne Ste 170Atlanta, GA 30322-1004
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJuly 3, 2019
Last NPPES UpdateJanuary 20, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2026
NPI 1174185763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in GA · PSY004308
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

12 EXECUTIVE PARK DR NE, Atlanta, GA 30329

Secondary Practice Location 1

Location 11441 Clifton Rd NEAtlanta, GA 30322-1004 · Phone (404) 712-5667

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Anastacia A. Nichols Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7719218155
PECOS Enrollment IDI20191015003738
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30329 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$172.43 typical visit price
range $56.84 – $172.43
Typical copayment $43.10 (range $14.21 – $43.10)
Most-billed visit code 99205
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.83
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Student in an Organized Health Care Education/Training Program
12 EXECUTIVE PARK DR NE, SUITE 331
ATLANTA, GA 30329
Physical Therapist (Neurology)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Nurse Practitioner (Family)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Social Worker (Clinical)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Psychiatry & Neurology (Psychiatry)
12 EXECUTIVE PARK DR NE, CHILD PSYCHIATRY, SUITE 200
ATLANTA, GA 30329
Psychologist (Clinical)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Student in an Organized Health Care Education/Training Program
12 EXECUTIVE PARK DR NE, SUITE 331
ATLANTA, GA 30329
Psychiatry & Neurology (Neuromuscular Medicine)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Anastacia Nichols's NPI number?

The NPI number for Anastacia Nichols is 1174185763. It was assigned to this individual provider in the NPPES registry on July 3, 2019.

Where is Anastacia Nichols located?

Anastacia Nichols practices at 12 Executive Park Dr NE, Atlanta, GA 30329. The listed phone number is (404) 712-5667.

What is Anastacia Nichols's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Anastacia Nichols enrolled in Medicare?

Yes. Anastacia Nichols is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Anastacia Nichols accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Anastacia Nichols as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Anastacia Nichols was last updated on January 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.