Shameia Nicole Mixon, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC012231 Issued in GA

Practice address

6251 Baltusrol Trce
Fairburn, GA 30213-5126

Phone

(404) 936-4030

NPI assigned

Feb 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shameia Nicole Paschal Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Home of Wellness Counseling Services, LLC

  • Professional Counselor
  • College Park, GA
  • NPI 1982274403
  NPD Authorized official

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1760981195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5436 RIVERDALE RD STE 125C",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303496938",
            "telephone_number": "470-240-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6251 BALTUSROL TRCE",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302135126",
            "telephone_number": "404-936-4030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1017 Fayetteville Rd SE Ste B",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303162932",
            "country_code": "US",
            "telephone_number": "470-240-1556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIXON",
        "first_name": "SHAMEIA",
        "middle_name": "NICOLE",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC006288",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC012231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAMEIA",
            "last_name": "PASCHAL",
            "middle_name": "NICOLE",
            "credential": "LAPC, NCC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Fairburn, GA
• Providers in Fairburn, 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 28, 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.