Shelley Lynn Burke, MA, LPC, QMHP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC009914 Issued in GA

Practice address

1551 Jennings Mill Rd Unit 3000B
Watkinsville, GA 30677-7280

Phone

(706) 389-8143

NPI assigned

Oct 8, 2009

Last updated

Nov 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Counseling, Mindfulness, & Recovery LLC

  • Professional Counselor
  • Watkinsville, GA
  • NPI 1427694918
  NPD Authorized official

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1144555186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 JENNINGS MILL RD UNIT 3000B",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777280",
            "telephone_number": "706-389-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 JENNINGS MILL RD UNIT 3000B",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777280",
            "telephone_number": "706-389-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "SHELLEY",
        "middle_name": "LYNN",
        "credential": "MA, LPC, QMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3566",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher K Brune, PA-C
• Laurie Bryan, RBT
• Dennis G Bullock, MD
• Amanda Burgamy, PMHNP-BC
• Sawyer McKinley Burke
• Donald Anthony Burroughs, M.A.,L.P.C.
• Butler Surgical Assistants, LLC
• Katherine Butler
• Terribia Sade Bynum
• Robert Roy Byrne, M.D.

• Professional Counselor in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Professional Counselor in Georgia

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

Verify at the official NPI Registry.