Individual provider Active NPI

Shondra Wilbanks, LPC

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1588938740
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC 007627 Issued in GA
Practice address
1830 Water PL SE
Suite 200
Atlanta, GA 30339-7407
Phone
(770) 916-9031
NPI assigned
Mar 5, 2012
Last updated
Sep 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC 007627 GA Primary

Addresses

Primary practice location

1830 Water PL SE
Suite 200
Atlanta, GA 30339-7407

Mailing address

1830 Water PL SE
Suite 200
Atlanta, GA 30339-7407
Phone (770) 916-9031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC 007627GAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1588938740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 WATER PL SE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303397407",
            "telephone_number": "770-916-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 WATER PL SE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303397407",
            "telephone_number": "770-916-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBANKS",
        "first_name": "SHONDRA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC 007627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.