Active NPI
Ronda Shirley
- Marriage & Family Therapist
- Macon, GA
National Provider Identifier
1770025678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT001503
- Practice address
- 1813 Long Ridge Dr
Macon, GA 31211-1611 - Phone
- (478) 974-7002
- NPI assigned
- Nov 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT001503 | GA | Primary |
Addresses
Primary practice location
1813 Long Ridge Dr
Macon, GA 31211-1611
Mailing address
4658 Presidential Pkwy # 1264
Macon, GA 31206-8708
Phone (478) 951-8776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240207002931 | GA | Practitioner - Marriage and Family Therapist | 3476996349 | Practice locations: Macon, GA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT001503 | GA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shirley Therapeutic and Consulting Services, LLC | Marriage & Family Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Marriage & Family Therapist
- Warner Robins, GA
- NPI 1417463571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1770025678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4658 PRESIDENTIAL PKWY # 1264",
"city": "MACON",
"state": "GA",
"postal_code": "312068708",
"telephone_number": "478-951-8776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1813 LONG RIDGE DR",
"city": "MACON",
"state": "GA",
"postal_code": "312111611",
"telephone_number": "478-974-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRLEY",
"first_name": "RONDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-08",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "MFT001503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.