Kadie Graham Shanders, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC014821 Issued in GA

Practice address

3116 N Oak Street Ext
Valdosta, GA 31602-1007

Phone

(229) 671-3500

NPI assigned

Jun 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

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.

• Behavioral Health Services of South Georgia

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valdosta, GA
  • NPI 1801932371
  Medicare reassignment NPD

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1568204618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 N OAK STREET EXT STE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025910",
            "telephone_number": "229-671-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 N OAK STREET EXT",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021007",
            "telephone_number": "229-671-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANDERS",
        "first_name": "KADIE",
        "middle_name": "GRAHAM",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC014821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dilleta Andree Shackelford, APRN
• Shaiva B Shah, PHARMD
• Vishal Shah
• Rabail Saeed Shaikh
• Umar Muhammad Shaikh
• Hala Sharma, MD
• Shaleekha Sharma, MD
• Vibhuti Sharma, M.D.
• John Michael Sharon, M.D.
• Christa Shaw

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.