Shahagony Banks, CIT
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Douglasville, GA
NPI 1376168302 · NPPES record last updated Jun 16, 2020
Key facts
- NPI
- 1376168302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 2109 Fairburn Rd Ste a
Douglasville, GA 30135-1037 - Phone
- (770) 726-7958
- NPI assigned
- Jun 16, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthqwest LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
2109 Fairburn Rd Ste a
Douglasville, GA 30135-1037
Mailing address
708 Sable Chase Blvd
McDonough, GA 30253-3463
Phone (770) 412-2532
Other providers in Douglasville, GA
- Monica Lindsey Ballard
- Tonika M Ballard
- Daisy Bisola Balogun
- Michele Balthrope
- Quiera Banks
- Stephanie Banks
- Bhumika Banugaria
- Andrew Paul Barak
- Keturah Barnard
- Ivorine Barnes
All providers in Douglasville, GA · Addiction (Substance Use Disorder) 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 Jun 16, 2020. 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.