Shakia Cooks Fuller, LAPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

APC006925 Issued in GA

Practice address

2705 Davis Mill Rd
Hephzibah, GA 30815-6912

Phone

(706) 414-8257

NPI assigned

Nov 5, 2019

Sex

Female

Sole proprietor

Yes

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

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1295379907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 DAVIS MILL RD",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308156912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 DAVIS MILL RD",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308156912",
            "telephone_number": "706-414-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SHAKIA",
        "middle_name": "COOKS",
        "credential": "LAPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC006925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Fluker
• Melinda Frank
• Mary E Franklin, PT
• Fred M Hannan Sr, D.D.S., PC
• Freeman'S Second Time Around Healthcare Services
• Ruben Garnett
• Gentle &Loving Heart Home Care LLC
• Georgia Department of Human Resources
• Georgia Department of Human Resources
• Georgia Department of Human Resources

• All providers in Hephzibah, GA
• Mental Health 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.