Shatasha Mitchell, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC013219 Issued in GA

Practice address

404 N Lake Dr
Perry, GA 31069-8402

Phone

(478) 662-0606

Fax

(478) 988-0592

NPI assigned

Oct 30, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Know Your Worth Counseling and Coaching

  • Professional Counselor
  • Perry, GA
  • NPI 1275256141
  NPD Authorized official
• Counseling of Central Georgia

  • Professional Counselor
  • Warner Robins, GA
  • NPI 1063056265
  NPD

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663977600000",
    "number": "1811531106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N LAKE DR",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310698402",
            "telephone_number": "478-662-0606",
            "fax_number": "478-988-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N LAKE DR",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310698402",
            "telephone_number": "478-662-0606",
            "fax_number": "478-988-0592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Corporate Pointe Ste 117",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310883440",
            "country_code": "US",
            "telephone_number": "478-396-4695",
            "fax_number": "478-352-0018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHATASHA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2022-09-24",
        "certification_date": "2022-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC013219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Middle Georgia Anesthesiology, LLC
• Middle Georgia Podiatry P.C.
• Middle Georgia Primary Care
• Middle Georgia Primary Care, PC
• Savanna Millican
• Skylar Mizell, DMD
• Ross Montgomery, O.D.
• Jasia L Moody
• Sarah Jennings Moody, OTR/L
• Amanda Gail Moore, LMFT

• Professional Counselor in Perry, GA
• Providers in Perry, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2022; 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.