SHANNON WILKERSON (NPI# 1518331362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518331362 |
| Entity Type | Individual |
| Full Name | SHANNON WILKERSON |
| Credential | MA |
| Practice Address |
3040 Highlands Pkwy, Ste G Smyrna GA 30082 |
| Mailing Address |
3040 Highlands Pkwy Se Ste G Smyrna GA 30082-5178 |
| Practice Telephone | 6788388333 |
| Practice Fax Number | 6788388444 |
| Mailing Telephone | 6788388333 |
| Mailing Fax Number | 6788388444 |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2016-08-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | APC 004081 | GA | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
APC004081 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943009 | Shannon Wilkerson | Counselor | 3801 North Blvd, Baton Rouge, LA 70806-3825 | 2020-05-14 |
| Street Address |
3040 HIGHLANDS PKWY, STE G |
| City | SMYRNA |
| State | GA |
| Zip Code | 30082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528600335 | Arden Constance Mobley | Occupational Therapist | 3200 Highlands Parkway Suite 150, Smyrna, GA 30082 | 2019-10-14 |
| 1386185916 | Nicholas Andrews | Behavior Technician | 5034 Laurel Bridge, Smyrna, GA 30082 | 2017-03-15 |
| 1235529611 | Frances Offiah Idowu | Nurse Practitioner | 3240 South Cobb Drive, Smyrna, GA 30082 | 2015-01-23 |
| 1053717850 | Deena Altman Spital | Physician Assistant | 400 Technology Ct, Suite J, Smyrna, GA 30082 | 2014-11-06 |
| 1487964193 | Revive Athletics, Inc | Counselor | 460 Bourne Drive, Smyrna, GA 30082 | 2010-10-15 |
| 1386956746 | Kalpit C Patel | Family Medicine | 4480 N Cooper Lake Rd Se Ste 100, Smyrna, GA 30082 | 2010-07-13 |
| 1285826800 | David Goziem Nwabunor | Emergency Medicine | 415 Oak Brook Ct Se, Smyrna, GA 30082 | 2007-08-16 |
| 1437357373 | Amit M Patel | Plastic Surgery | 3968 Felton Hill Rd Sw, Ste 100, Smyrna, GA 30082 | 2007-07-03 |
| 1225103849 | Daniel C Norris Dds PC | Dentist | 620 Concord Rd, Smyrna, GA 30082 | 2006-11-21 |
| 1215001888 | Wellstar Urgent Care At Cooper Lake, LLC | Emergency Medicine | 4480 N Cooper Lake Road Se, Suite 100, Smryna, GA 30082 | 2006-11-17 |
| Find all providers in zip 30082 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619576865 | Therapy Pond, LLC | Counselor | 1262 Concord Rd Se Ste 200, Smyrna, GA 30080-5307 | 2020-10-20 |
| 1316576598 | Victoria Counseling & Consulting, LLC | Counselor | 3059 S Cobb Dr Se, Smyrna, GA 30080-7809 | 2020-04-08 |
| 1932735495 | Thomas W Jones IIi | Counselor | 5182 Afton Way Se, Smyrna, GA 30080-2669 | 2020-03-17 |
| 1326508078 | Davonna Ashley Scott | Counselor | 1402 Vinings Trl Se, Smyrna, GA 30080-8642 | 2019-03-20 |
| 1003386400 | Jarrod Keith Harris | Counselor | 5199 Whiteoak Ave Se, Smyrna, GA 30080-7424 | 2018-11-28 |
| 1285101196 | Jennifer Allen | Counselor | 3010 Denny Brooke Ln, Smyrna, TN 37167-3968 | 2018-10-29 |
| 1154809192 | Gloria Jean Fisher | Counselor | 2722 Cottesford Dr Se, Smyrna, GA 30080-2188 | 2018-08-01 |
| 1851877369 | Robyn N Minefee | Counselor | 2642 Davenport St Se, Smyrna, GA 30080-2303 | 2018-07-17 |
| 1326537051 | Fatimah N Muhammad | Counselor | 2067 Lake Park Dr Se Apt G, Smyrna, GA 30080-7628 | 2018-05-08 |
| 1316443237 | Ashley L Heggins | Counselor | 5056 Laurel Bridge Dr Se, Smyrna, GA 30082-4833 | 2018-03-30 |
| Find all providers in SMYRNA | ||||
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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.