Shanavia Echols

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC015106 Issued in GA

Practice address

175 Gwinnett Dr
Lawrenceville, GA 30046-8444

Phone

(678) 744-9471

NPI assigned

Jun 26, 2015

Last updated

Dec 5, 2024By the provider in NPPES

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1154703007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 GWINNETT DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468444",
            "telephone_number": "678-744-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 GWINNETT DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468444",
            "telephone_number": "678-744-9471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Fairway Dr",
            "address_2": "102",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334411814",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECHOLS",
        "first_name": "SHANAVIA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC015106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.