Active NPI
Shanequa Mussa, CADC11
- Addiction (Substance Use Disorder) Counselor
- Lagrange, GA
National Provider Identifier
1699522037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1131
- Practice address
- 229 S Davis Rd
Lagrange, GA 30241-2608 - Phone
- (800) 805-6989
- NPI assigned
- May 3, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1131 | GA | Primary |
Addresses
Primary practice location
229 S Davis Rd
Lagrange, GA 30241-2608
Mailing address
6872 Omaha Dr.
Midland, GA 31820
Phone (706) 304-9675
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1131 | GA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1699522037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6872 OMAHA DR.",
"city": "MIDLAND",
"state": "GA",
"postal_code": "31820",
"telephone_number": "706-304-9675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 S DAVIS RD",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302412608",
"telephone_number": "800-805-6989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSSA",
"first_name": "SHANEQUA",
"credential": "CADC11",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-03",
"last_updated": "2024-05-03",
"certification_date": "2024-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "GA",
"license": "1131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
- Mrs Homecare, Inc. (Mrs of Lagrange)
- Keerthana Dwarakan Mugundu, MD
- Ashley Murphy
- Kennedy Murphy, B.S, D.D.S
- Tiffany Danielle Murphy, NP
- N/a at Present Time, Will Be Working Contractprivateduty
- Jasmine Naheed, M.D.
- Madhavi M Naik, M.D.
- National Vision, Inc.
- National Vision, Inc. (America's Best Contacts & Eyeglasses)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.