Shakierra Dawson – Professional Counselor

Key facts

NPI: 1316374697
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: 003322 (GA)
Practice address: 3120 N Oak Street Ext Ste C
Valdosta, GA 31602-5910
Phone: (229) 671-6100
Fax: (229) 671-6774
NPI assigned: Oct 2, 2013
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

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.

Albany Area CSB Public Health or Welfare Agency · Blakely, GA · NPI 1699839969

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
003322	GA	MD	Professional Counselor

Practice roles

Organization	Specialty	Status	New patients
Albany Area CSB		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Professional Counselor	101YP2500X	003322	GA	Yes

Addresses

Primary practice location

3120 N Oak Street Ext Ste C
Valdosta, GA 31602-5910

Mailing address

334 Tifton Eldorado Rd
Tifton, GA 31794-9497
Phone (229) 391-2300

Other identifiers

Identifier	Type	State	Issuer
003322	Other	GA	LICENSE

Other providers in Valdosta, GA

All providers in Valdosta, GA · Professional Counselor in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.