Individual provider Active NPI

Shilpa Shah, LPC

  • Professional Counselor
  • College Park, GA
National Provider Identifier
1033380811
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC003255 Issued in GA
Practice address
1919 John Wesley Ave
College Park, GA 30337-3605
Phone
(404) 762-9190
NPI assigned
Mar 19, 2008
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC003255 GA Primary

Addresses

Primary practice location

1919 John Wesley Ave
College Park, GA 30337-3605

Mailing address

1919 John Wesley Ave
College Park, GA 30337-3605
Phone (404) 762-9190

Other identifiers 1

IdentifierTypeStateIssuer
LPC003255OtherGALICENSED PROFESSIONAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC003255GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Odyssey Family Counseling Center Corporation Professional CurrentSince Nov 10, 2024 Accepting new patients
The Potters House Family and Children Treatment Center Past Accepting new patients
The Potters House Family and Children Treatment Center Past Accepting new patients

Locations

1919 John Wesley Ave
College Park, GA 30337
Phone (404) 762-9190

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/odysseycounseling/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1033380811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 JOHN WESLEY AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303373605",
            "telephone_number": "404-762-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 JOHN WESLEY AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303373605",
            "telephone_number": "404-762-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHILPA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL",
            "identifier": "LPC003255",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.