Active NPI
Shonta Harper, LPC
- Professional Counselor
- Saint Marys, GA
National Provider Identifier
1154897296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 010142
- Practice address
- 708 Osborne St Ste 104
Saint Marys, GA 31558 - Phone
- (229) 591-4772
- Fax
- (855) 793-1274
- NPI assigned
- Oct 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 010142 | GA | Primary |
Addresses
Primary practice location
708 Osborne St Ste 104
Saint Marys, GA 31558
Mailing address
708 Osborne St Ste 104
Saint Marys, GA 31558-8497
Phone (912) 882-7383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250428001302 | GA | Practitioner - Mental Health Counselor | 6800312414 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010142 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middle Flint Area Community Service Board | Current | Accepting new patients | |
| Middle Flint Area Community Service Board | Multi-Specialty | Current | Accepting new patients |
| Middle Flint Area Community Service Board | Current | Accepting new patients | |
| Arete Behavioral Health Corp | Professional | Past | Accepting new patients |
Locations
415 N Jackson St
Americus, GA 31709
Phone (229) 815-5454
940 GA Highway 96
Ste A
Warner Robins, GA 31088
Phone (478) 988-7100
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Fort Valley, GA
- NPI 1366521932
GA, Multi-Specialty
-
- Public Health or Welfare Agency
- Americus, GA
- NPI 1093784720
-
- Community/Behavioral Health Agency
- Americus, GA
- NPI 1487822599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1154897296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 OSBORNE ST STE 104",
"city": "SAINT MARYS",
"state": "GA",
"postal_code": "315588497",
"telephone_number": "912-882-7383",
"fax_number": "855-793-1274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 OSBORNE ST STE 104",
"city": "SAINT MARYS",
"state": "GA",
"postal_code": "31558",
"telephone_number": "229-591-4772",
"fax_number": "855-793-1274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARPER",
"first_name": "SHONTA",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-16",
"last_updated": "2024-04-30",
"certification_date": "2020-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "GA",
"license": "010142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Marys, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.