Provider Demographics
NPI:1861722407
Name:NHLIZIYO, SIPHIWE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SIPHIWE
Middle Name:
Last Name:NHLIZIYO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SIPHIWE
Other - Middle Name:
Other - Last Name:SNIPES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4068 HIGH COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-4267
Mailing Address - Country:US
Mailing Address - Phone:770-316-0798
Mailing Address - Fax:678-550-6360
Practice Address - Street 1:110 EVANS MILL DR STE 305
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-1623
Practice Address - Country:US
Practice Address - Phone:678-348-8390
Practice Address - Fax:678-550-6360
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0030021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403268300Medicaid