NPIMap

Organization Active NPI

Shereka Shaw, LPC

  • Community/Behavioral Health Agency
  • Jonesboro, GA
National Provider Identifier
1619363884
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LPC007419 Issued in GA
Legal business name
SHEREKA SHAW, LPC
Practice address
9421 Forest Knoll Dr
Jonesboro, GA 30238-5755
Phone
(404) 234-4570
NPI assigned
Apr 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Mrs. Shereka Shunta' Shaw, LPC
Title
Licensed Professional Counselor
Phone
(404) 234-4570

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X LPC007419 GA
Community/Behavioral Health Agency 251S00000X LPC007419 GA Primary
Early Intervention Provider Agency 252Y00000X LPC007419 GA
Preferred Provider Organization 305R00000X LPC007419 GA
Psychiatric Residential Treatment Facility 323P00000X LPC007419 GA

Addresses

Primary practice location

9421 Forest Knoll Dr
Jonesboro, GA 30238-5755

Mailing address

9421 Forest Knoll Dr
Jonesboro, GA 30238-5755
Phone (404) 234-4570

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1619363884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9421 FOREST KNOLL DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302385755",
            "telephone_number": "404-234-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9421 FOREST KNOLL DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302385755",
            "telephone_number": "404-234-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEREKA SHAW, LPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "SHEREKA",
        "authorized_official_middle_name": "SHUNTA'",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "404-234-4570",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": "LPC007419",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC007419",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "GA",
            "license": "LPC007419",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "LPC007419",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "GA",
            "license": "LPC007419",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.