ETHEREDGE AND SHELTON, LLC (NPI# 1164668869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164668869 |
| Entity Type | Organization |
| Organization Name | ETHEREDGE AND SHELTON, LLC |
| Practice Address |
207 E Hiram St Atlanta TX 75551-2661 |
| Mailing Address |
1204 Holly St Atlanta TX 75551-1842 |
| Practice Telephone | 9037965061 |
| Mailing Telephone | 9037965061 |
| Enumeration Date | 2008-12-30 |
| Last Update Date | 2008-12-30 |
| Authorized Official Name | GAY HILL ETHEREDGE (PRESIDENT) |
| Authorized Official Telephone | 9032777732 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
02075 | TX | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
00276 | TX | Behavioral Health & Social Service Providers |
| Street Address |
207 E HIRAM ST |
| City | ATLANTA |
| State | TX |
| Zip Code | 75551-2661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346879921 | Wendy Sue Willoughby | Pharmacy Technician | 201 Us Hwy 59, Atlanta, TX 75551 | 2020-04-06 |
| 1689154759 | Bobbye Francene Rankin | Physical Therapy Assistant | 109 Cr 3544, Atlanta, TX 75551 | 2018-08-18 |
| 1447668538 | Winnie-stowell Hospital District | Skilled Nursing Facility | 1104 S. William Street, Atlanta, TX 75551 | 2014-08-01 |
| 1912176983 | Glenna B Frost | Speech-Language Pathologist | 1001 West Main Street, Atlanta, TX 75551 | 2008-02-25 |
| 1043438823 | Shelia Kaye Langbartels | Optometrist | 201 Hwy. 59 South, Atlanta, TX 75551 | 2007-04-24 |
| 1598838583 | Tim C Hogan | Dentist | 402 S William St, Hogan Dental Clinic, Atlanta, TX 75551 | 2006-11-16 |
| 1003991290 | Jimmy Glenn Stillwell | Nurse Anesthetist, Certified Registered | 1007 S Williams, Atlanta Memorial Hospital, Atlanta, TX 75551 | 2006-10-26 |
| 1336248376 | Miles Drug Company | Pharmacist | 122 N East St, Atlanta, TX 75551 | 2006-09-22 |
| 1417050667 | Danny Warren Addington | Dentist | 307 East Hiram, Atlanta, TX 75551 | 2006-09-06 |
| 1912917899 | Atlanta Nursing Homes Inc. | Skilled Nursing Facility | 200 Live Oak, Atlanta, TX 75551 | 2006-08-09 |
| Find all providers in zip 75551 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617495 | Anita S White | Social Worker | 981 Cleveland Ave, Atlanta, GA 30344-6717 | 2020-10-18 |
| 1164038394 | Alex Kyle Allen | Social Worker | 10 Surry County Pl Nw, Atlanta, GA 30318-1412 | 2020-09-22 |
| 1679189872 | Nicole Melissa King | Social Worker | 130 Arizona Ave Ne Unit 408, Atlanta, GA 30307-2257 | 2020-09-22 |
| 1245845288 | Jennie Gray Mulligan | Social Worker | 1911 Hallman St Ne, Atlanta, GA 30317-1001 | 2020-09-15 |
| 1518577253 | Chastity Quave | Social Worker | 790 Huff Rd Nw Apt 2062, Atlanta, GA 30318-4344 | 2020-08-07 |
| 1407465354 | Lavender Grove Psychotherapy | Social Worker | 3755 Redwine Rd, Atlanta, GA 30344-5899 | 2020-07-27 |
| 1861001174 | Whitney Flemister | Social Worker | 3961 Princeton Lakes Way Sw, Atlanta, GA 30331 | 2020-07-23 |
| 1518576883 | Dream Again Therapy Services LLC | Social Worker | 3401 Norman Berry Dr Ste 254a, Atlanta, GA 30344-5102 | 2020-07-23 |
| 1245848878 | Chalon Dabney | Social Worker | 1155 Perimeter Ctr, Atlanta, GA 30338-5463 | 2020-07-20 |
| 1649888595 | Adrienne Bryant Smith | Social Worker | 2099 Glenwood Ave Se, Atlanta, GA 30316-2358 | 2020-07-16 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.