Individual provider Active NPI

Shonta Harper, LPC

  • Professional Counselor
  • Saint Marys, GA
National Provider Identifier
1154897296
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
010142 Issued in GA
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

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428001302 GA Practitioner - Mental Health Counselor 6800312414 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010142GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Flint Area Community Service Board CurrentSince Mar 24, 2025 Accepting new patients
Middle Flint Area Community Service Board Multi-Specialty Current Accepting new patients
Middle Flint Area Community Service Board CurrentSince Mar 24, 2025 Accepting new patients
Arete Behavioral Health Corp Professional PastSince Mar 16, 2020 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.

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

Verify at the official NPI Registry.