Jaquita Shorts

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC010510 Issued in GA

Practice address

1705 Pennslyvania Ave
McDonough, GA 30252

Phone

(678) 853-5849

NPI assigned

Dec 22, 2015

Last updated

Nov 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Embodied Therapy Services, LLC

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  • NPI 1205694544

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• Healing Heartz Therapy Soulutions

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• Vmillerk Enterprises LLC

  dba DNM Health Services

  • Counselor
  • McDonough, GA
  • NPI 1508332248
  NPD

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604793600000",
    "number": "1518322395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9109 BOSTON HARBOR WAY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302528951",
            "telephone_number": "770-378-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 PENNSLYVANIA AVE",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30252",
            "telephone_number": "678-853-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTS",
        "first_name": "JAQUITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2020-11-08",
        "certification_date": "2020-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010510",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001529",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thriveworks.com",
            "affiliation": "N",
            "endpointDescription": "therapy practices",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "counseling",
            "address_1": "1705 pennslyvania ave",
            "city": "mcdonough",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sheppard's Progressive Rehabilitation (Children's Advanced Therapeutic Services)
• Jazmin Sherald
• Paris C Shields, LCSW
• Karol Short
• Antuan Shorter
• Gurkirat Singh Sidhu
• Signature Behavioral Services LLC
• Robert T Sikes, PA-C.
• Sandra Elaine Silbernagel, RT
• Diana E. Silva, FNP-C

• Professional Counselor in McDonough, GA
• Providers in McDonough, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2020; 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.