Self Mental Health LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SELF MENTAL HEALTH LLC

Practice address

202 Estelle St
Wrens, GA 30833-1125

Phone

(706) 250-0896

Fax

(706) 940-4761

NPI assigned

Oct 14, 2026

Last updated

Oct 14, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shakia Fuller, LPCCNPI 1295379907

Title

Ceo

Phone

(706) 250-0896

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shakia Cooks Fuller, LAPC

  • Mental Health Counselor
  • Hephzibah, GA
  • NPI 1295379907
  NPD (past) Authorized official

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

{
    "created_epoch": "1791936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791936000000",
    "number": "1356247761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163",
            "city": "WRENS",
            "state": "GA",
            "postal_code": "308330163",
            "telephone_number": "706-250-0896",
            "fax_number": "706-940-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 ESTELLE ST",
            "city": "WRENS",
            "state": "GA",
            "postal_code": "308331125",
            "telephone_number": "706-250-0896",
            "fax_number": "706-940-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-14",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "SHAKIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-250-0896",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Wrens, GA
• Providers in Wrens, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.

Verify at the official NPI Registry.