Active NPI
Reshundra Shaffer, LMSW
- Mental Health Counselor
- Ackerman, MS
National Provider Identifier
1063974137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- M8800
- Practice address
- 100 Old Sturgis Rd
Ackerman, MS 39735-6600 - Phone
- (662) 285-6225
- Fax
- (662) 285-6226
- NPI assigned
- Apr 5, 2019
- Last updated
- Apr 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | M8800 | MS | Primary |
Addresses
Primary practice location
100 Old Sturgis Rd
Ackerman, MS 39735-6600
Mailing address
302 N Jackson St
Starkville, MS 39759-2504
Phone (662) 323-9318
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
| License | State | Type | Specialty |
|---|---|---|---|
| M8800 | MS | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554422400000",
"number": "1063974137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 N JACKSON ST",
"city": "STARKVILLE",
"state": "MS",
"postal_code": "397592504",
"telephone_number": "662-323-9318",
"fax_number": "662-323-5553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 OLD STURGIS RD",
"city": "ACKERMAN",
"state": "MS",
"postal_code": "397356600",
"telephone_number": "662-285-6225",
"fax_number": "662-285-6226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "RESHUNDRA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-05",
"last_updated": "2019-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": "M8800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ackerman, MS
- Pioneer Health Services of Choctaw County, LLC (Pioneer Medical Center)
- Pioneer Health Services of Choctaw County, LLC (Pioneer Community Hospital of Choctaw)
- Pioneer Health Services of Choctaw County, LLC (Choctaw County Nursing Center)
- Positive Thinking LLC
- Harmon Sidney Prosser, MD
- Jill Marie Shaw, FNP-BC
- Phillip Smith
- Terri Denise Swilley
- Lauren Rae Herring Thames, DMD
- The Columbus Orthopaedic Clinic, P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.