Shirley R. Koors, MMFT, LPC-MHSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2742 Issued in TN

Practice address

942 County Road 609
Athens, TN 37303

Phone

(931) 797-8461

NPI assigned

Mar 2, 2007

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

Other identifiers 1

Other names 1

• Shirley Gevedon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1205964863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 COUNTY ROAD 609",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373036365",
            "telephone_number": "931-797-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 COUNTY ROAD 609",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "37303",
            "telephone_number": "931-797-8461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1605 Jennifer Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "384015431",
            "country_code": "US",
            "telephone_number": "931-797-8461",
            "fax_number": "877-904-0972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOORS",
        "first_name": "SHIRLEY",
        "middle_name": "R.",
        "credential": "MMFT, LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "2742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525402",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "GEVEDON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susanna Joy King, LMSW
• Chad Kingery, LCPC, LAC
• Melissa Suzanne Kinser, PSY PHD
• Heather Michelle Kitchens, OTR/L
• Connie B Knox
• Zakary K Kramer, PTA
• Julie B Kross
• Lindsey Marie Lamons, FNP-C
• Kurtis Lansdell, CRNA
• Joseph C Lauterbach, M.D.

• Mental Health Counselor in Athens, TN
• Providers in Athens, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; 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.