Active NPI
Shanithia Kendrick, LPC
- Counselor
- Fayetteville, GA
National Provider Identifier
1346740222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 016232
- Practice address
- 105 Banks Sta # 1095
Fayetteville, GA 30214-7503 - Phone
- (404) 777-4604
- NPI assigned
- Feb 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 016232 | GA | Primary |
| Mental Health Counselor | 101YM0800X | 016232 | GA |
Addresses
Primary practice location
105 Banks Sta # 1095
Fayetteville, GA 30214-7503
Mailing address
105 Banks Sta # 1095
Fayetteville, GA 30214-7503
Phone (404) 777-4604
Other practice location 1
1903 Phoenix Blvd Ste 200
Atlanta, GA 30349-5700
Phone (678) 335-9010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016232 | GA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Changing Phases Behavioral Support, Inc | Past | Accepting new patients | |
| Georgia Counseling Inc | Past | Accepting new patients | |
| Access Mental Health Agency, LLC | Past | Accepting new patients |
Organizations & group practices 3
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
- Atlanta, GA
- NPI 1881848174
-
- Community/Behavioral Health Agency
- Marietta, GA
- NPI 1497094205
-
- Community/Behavioral Health Agency
- Stockbridge, GA
- NPI 1043677362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770163200000",
"number": "1346740222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 BANKS STA # 1095",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147503",
"telephone_number": "404-777-4604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 BANKS STA # 1095",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147503",
"telephone_number": "404-777-4604"
}
],
"practiceLocations": [
{
"address_1": "1903 Phoenix Blvd Ste 200",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303495700",
"country_code": "US",
"telephone_number": "678-335-9010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENDRICK",
"first_name": "SHANITHIA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-16",
"last_updated": "2026-02-04",
"certification_date": "2026-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "016232",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "016232",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.