Jaylyn Clark Shifrin, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY004638 Issued in GA

Practice address

3502 Harvest Moon Trce SW
Lilburn, GA 30047-2468

Phone

(229) 977-0834

NPI assigned

Nov 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Clinical Psychologist

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Rhode Island Counseling Associates LLC

  • Mental Health Counselor
  • Cranston, RI
  • NPI 1336638303
  Medicare reassignment NPD

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1508469537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 HARVEST MOON TRCE SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472468",
            "telephone_number": "229-977-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 HARVEST MOON TRCE SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472468",
            "telephone_number": "229-977-0834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Reservoir Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029206032",
            "country_code": "US",
            "telephone_number": "401-259-0340",
            "fax_number": "401-213-8538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIFRIN",
        "first_name": "JAYLYN",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004638",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS02382",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Pocock Shah, MD
• Jatayah Nicole Sheed, MD
• Lauren D Sheller, OTR/L
• Shepherd Home Care LLC
• Shifa Medical Supply LLC
• Shital U Shilotri
• Darius Shirley
• Shore Language Services, LLC
• Shriji Healthcare LLC
• Lena Gabrielle Simon

• Clinical Psychologist in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; 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.