ROBERT SHACKELFORD (NPI# 1205215654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205215654 |
| Entity Type | Individual |
| Full Name | ROBERT SHACKELFORD |
| Practice Address |
1100 Cesery Blvd Jacksonville FL 32211-5674 |
| Mailing Address |
97346 Bluff View Cir Yulee FL 32097-1917 |
| Practice Telephone | 9043337927 |
| Mailing Telephone | (904) 945-7867 |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2017-09-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MT3360 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114116365 | Robert H Shackelford | Dentist | 3915 Johns Creek Ct, Ste 110, Suwanee, GA 30024-1265 | 2007-10-23 |
| 1578633236 | Robert P Shackelford | Orthopaedic Surgery | 113 Airport Road, Suite 200, Sulphur Springs, TX 75482 | 2006-11-09 |
| 1568415362 | Robert L Shackelford | Chiropractor | 219 Sw Second St, Walnut Ridge, AR 72476-2335 | 2006-05-19 |
| 1568867786 | Robert Shackelford | Counselor | 2731 Nugget Ave, Lake Isabella, CA 93240-9456 | 2014-10-30 |
| 1164709499 | Robert Shackelford | Counselor | 165 Roanoke Rd, El Cajon, CA 92020-4015 | 2011-11-15 |
| 1609843028 | Robert Hillard Shackelford | Family Medicine | 201 N Breazeale Ave, Mount Olive, NC 28365-1603 | 2006-03-03 |
| Street Address |
1100 CESERY BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32211-5674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891744504 | Waleska Oquendo-tirado | General Practice | 1100 Cesery Blvd, Jacksonville, FL 32211-5674 | 2006-05-09 |
| 1114537073 | Darcellis Stinnette | Massage Therapist | 1100 Cesery Blvd, Jacksonville, FL 32211-5674 | 2020-08-05 |
| 1568016459 | Manuela Claudia Cismaru | Nurse Practitioner | 1100 Cesery Blvd, Jacksonville, FL 32211-5674 | 2019-07-29 |
| 1215598008 | Adrianne J Parris | Massage Therapist | 1100 Cesery Blvd, Jacksonville, FL 32211-5674 | 2019-06-24 |
| 1619536174 | Jessica Lynn Askew | Nurse Practitioner | 1100 Cesery Blvd, Jacksonville, FL 32211-5674 | 2019-06-10 |
| 1124683214 | Cherie Danielle Schaffner | Nurse Practitioner | 1100 Cesery Blvd, Jacksonville, FL 32211-5674 | 2019-05-05 |
| 1922572023 | Natasha T Ingram | Nurse Practitioner | 1100 Cesery Blvd, Jacksonville, FL 32211 | 2019-01-11 |
| 1750879201 | Jasmine Fair | Social Worker | 1100 Cesery Blvd, Jacksonville, FL 32211-5674 | 2018-04-30 |
| 1700399532 | Shannon Spaulding | Counselor | 1100 Cesery Blvd, Jacksonville, FL 32211-5674 | 2017-11-15 |
| 1053833293 | Amy Anne Buckley | Social Worker | 1100 Cesery Blvd, Jacksonville, FL 32211-5674 | 2017-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951758 | Ebs Childrens Therapy - Fl LLC | Behavioral Analyst | 5491 Dolphin Point Blvd, Jacksonville, FL 32211 | 2020-10-27 |
| 1700412822 | Marie Vernal | Social Worker | 6051 Arlington Expressway Suite 169, Jacksonville, FL 32211 | 2020-03-20 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| 1366089641 | Prophetic Healing Deliverance Ministry of Mysteries, Inc | Counselor | 8550-2 Lone Star Road, Jacksonville, FL 32211 | 2019-12-05 |
| 1922656370 | Timothy Richard Barron | Behavior Technician | 5633 Clifton Ln, Jacksonville, FL 32211 | 2019-08-29 |
| 1023583325 | Linnzi Marks | Behavioral Analyst | 6014 Wateredge Ln, Jacksonville, FL 32211 | 2018-10-12 |
| 1780160192 | Ganesh Healthcare of Jax LLC | Alzheimer Center (Dementia Center) | 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 | 2018-07-18 |
| 1902397276 | Chandra Harris Washington | In Home Supportive Care | 2712 Gaillardia Rd, Jacksonville, FL 32211 | 2018-05-22 |
| 1043730062 | Monica R Iskander | Dentist | 465 University Blvd N, Jacksonville, FL 32211 | 2017-06-21 |
| 1205366895 | Lilibeth Bundang Adona | Custodial Care Facility | 1818 Townsend Blvd, Jacksonville, FL 32211 | 2017-06-15 |
| Find all providers in zip 32211 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730730391 | Richard Painter | Marriage & Family Therapist | 6823 Argyle Forest Blvd, Jacksonville, FL 32244-5730 | 2019-09-25 |
| 1144874660 | Misty Williams | Marriage & Family Therapist | 3730 Oregon City St, Jacksonville, FL 32227-1719 | 2019-08-01 |
| 1356800080 | Lakisha Yolanda Carter | Marriage & Family Therapist | 4569 Cape Elizabeth Ct E, Jacksonville, FL 32277-3219 | 2019-03-12 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1447758289 | Stephanie Ann Murphy | Marriage & Family Therapist | 11543 Halethorpe Drive, Jacksonville, FL 32223 | 2018-01-26 |
| 1518419514 | Kristina Himmelberg | Marriage & Family Therapist | 1100 Cesery Blvd., Jacksonville, FL 32211 | 2016-10-26 |
| 1881054591 | Virginia M. Boney, Ph.d. Lmft, Pa | Marriage & Family Therapist | 7545 Centurion Parkway, #105, Jacksonville, FL 32256 | 2016-02-24 |
| 1104248731 | Alicia Mcdermott | Marriage & Family Therapist | 7044 Deer Lodge Cir, #109, Jacksonville, FL 32256-8551 | 2014-01-16 |
| 1538500103 | Rashel Lee Lauret | Marriage & Family Therapist | 110 Branchwood Dr, Suite B, Jacksonville, NC 28546-5900 | 2013-07-11 |
| 1245589910 | Josephine Gianna Moss | Marriage & Family Therapist | 12629 Steeplechase Ln, Jacksonville, FL 32223-3506 | 2012-09-10 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32211 |
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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.