Shaketha Blankenship, PHD, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC008522 Issued in GA

Practice address

2026 Barrington LN
Villa Rica, GA 30180-6954

Phone

(404) 409-7361

NPI assigned

Jun 15, 2021

Last updated

Jun 15, 2021By 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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1689242745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 BARRINGTON LN",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301806954",
            "telephone_number": "404-409-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 BARRINGTON LN",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301806954",
            "telephone_number": "404-409-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "SHAKETHA",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008522",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "GA",
            "license": "391660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.betterhelp.com/",
            "affiliation": "Y",
            "affiliationName": "Better help",
            "address_1": "2026 Barrington Ln",
            "city": "Villa Rica",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301806954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bio-Medical Applications of Georgia, Inc. (Fmcna Villa Rica)
• BJK Specimen LLC
• Wilbur Lew Blackman III, MPT
• Angela Blackshear
• Christina Blair
• Jacob Boateng
• Shandon Boddy
• Chelsea Grant Bode, M.ED., CCC-SLP
• William Todd Boleman, MD
• Bonnie Kristine Boles, M.D.

• Professional Counselor in Villa Rica, GA
• Providers in Villa Rica, 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 15, 2021; 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.