Shannon D Mullen-Magbalon, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PSY003406 Issued in GA

Practice address

229 Remington Ave
Thomasville, GA 31792-5599

Phone

(229) 200-3157

NPI assigned

Dec 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Mosaic Psychological Services, LLC

  • Psychologist
  • Thomasville, GA
  • NPI 1770011058
  NPD (past)

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1053640235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317990378",
            "telephone_number": "229-200-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 REMINGTON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925599",
            "telephone_number": "229-200-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN-MAGBALON",
        "first_name": "SHANNON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-16",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "GA",
            "license": "PSY003406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Moree, DMD
• Mosaic Psychological Services, LLC
• Mosaic Therapy Services, LLC
• Shirley A Moye
• Mrs Homecare, Inc.
• Mandy Beth Mullen, L.C.S.W.
• Dawn Oneal Muller, P.T.
• Carey Marie Mullis
• Keith W Munoz Sr., P.A.-C
• Murphy and Cox Pharmacy Inc

• Counseling Psychologist in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Counseling Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.