JAQUITA SHORTS


Address: 1705 Pennslyvania Ave, Mcdonough, GA 30252
Phone: 6788535849

JAQUITA SHORTS (NPI# 1518322395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518322395
Entity Type Individual
Full Name JAQUITA SHORTS
Practice Address 1705 Pennslyvania Ave
Mcdonough
GA 30252
Mailing Address 9109 Boston Harbor Way
Mcdonough
GA 30252-8951
Practice Telephone 6788535849
Mailing Telephone 7703784917
Enumeration Date 2015-12-22
Last Update Date 2020-11-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
LPC010510 GA Behavioral Health & Social Service Providers
N 106H00000X Marriage & Family Therapist MFT001529 GA Behavioral Health & Social Service Providers

Office Location

Street Address 1705 PENNSLYVANIA AVE
City MCDONOUGH
State GA
Zip Code 30252

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073114427 Publix Super Markets, Inc Durable Medical Equipment & Medical Supplies 3479 Highway 81 East, Mcdonough, GA 30252 2020-11-03
1770143547 Kevin Kirk Anderson Physical Therapist Dr. Kevin Anderson, 196 Lake Dow Rd, Mcdonough, GA 30252 2019-06-14
1912474537 Atlanta Neuromonitoring, LLC Psychiatry & Neurology 922 Highway 81 East # 242, Mcdonough, GA 30252 2018-11-01
1194271320 Christine Williams Breeden Registered Nurse 189 Irwin Drive, Mcdonough, GA 30252 2016-08-28
1356758973 Keisha Candies Counselor 125 Zack Hinton Pkwy, Mcdonough, GA 30252 2014-07-15
1093145666 Ceisha Shador Parks Counselor 6040 Winston Trace, Mcdonough, GA 30252 2013-11-19
1588939565 Tasha E Jones Counselor 1509 Bent River Cir, Mcdonough, GA 30252 2012-03-09
1598049447 Proactive Rehab, Inc Physical Therapist 50 Lawrenceville Street, Suite 100, Mcdonough, GA 30252 2011-10-10
1164706131 Michelle Lee Cone Pharmacist 1210 Bent Creek Dr, Mcdonough, GA 30252 2011-10-07
1609907559 Mcdonough Internal Medicine Internal Medicine 382 Racetrack Road, Mcdonough, GA 30252 2007-03-09
Find all providers in zip 30252

Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679180756 River Haven Counseling Center, LLC Counselor 103 Jonesboro Rd Ste K, Mcdonough, GA 30253-3169 2020-09-23
1598376006 Ltanya Daniel Counselor 207 Olde Town Way, Mcdonough, GA 30252-6887 2020-08-10
1043831605 Kourtney K Buchanan Counselor 8015 Chapman Ter, Mcdonough, GA 30252-8604 2020-05-05
1831730456 Shirley Tate Chambers Counselor 1270 Upchurch Rd, Mcdonough, GA 30252-8557 2019-10-04
1386285070 Koriand'r Comegys Counselor 1725 Pennsylvania Ave, Mcdonough, GA 30253-9118 2019-10-03
1295386167 Haley Reed Counselor 475 Crumbley Rd, Mcdonough, GA 30252-4412 2019-09-23
1629538277 Regina Yvette Davis Counselor 228 Daisy Cir, Mcdonough, GA 30252-1040 2019-03-20
1619404092 Sonya Snow Counselor 1944 Brannan Road, Mcdonough, GA 30253-2217 2017-05-17
1255781332 Javonne Darling Counselor 801 Colwell Ln, Mcdonough, GA 30253-8082 2016-06-20
1558718700 Tara Zellous Counselor 1775 Pennsylvania Ave, Mcdonough, GA 30253-9118 2016-05-18
Find all providers in MCDONOUGH

Competitor

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City MCDONOUGH
Zip Code 30252

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Dataset Information

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.

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