SHEREKA SHAW, LPC (NPI# 1619363884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619363884 |
| Entity Type | Organization |
| Organization Name | SHEREKA SHAW, LPC |
| Practice Address |
9421 Forest Knoll Dr Jonesboro GA 30238-5755 |
| Practice Telephone | 4042344570 |
| Mailing Telephone | 4042344570 |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |
| Authorized Official Name | MRS. SHEREKA SHUNTA' SHAW (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Telephone | 4042344570 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | LPC007419 | GA | Agencies |
| N | 252Y00000X | Early Intervention Provider Agency | LPC007419 | GA | Agencies |
| N | 305R00000X | Preferred Provider Organization | LPC007419 | GA | Managed Care Organizations |
| N | 323P00000X | Psychiatric Residential Treatment Facility | LPC007419 | GA | Residential Treatment Facilities |
| Y | 251S00000X | Community/Behavioral Health | LPC007419 | GA | Agencies |
| Street Address |
9421 FOREST KNOLL DR |
| City | JONESBORO |
| State | GA |
| Zip Code | 30238-5755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366969636 | K&p Gentle Hnads Homecare | Home Health | 772 Pointe South Pkwy, Apt. 501, Jonesboro, GA 30238 | 2017-08-27 |
| 1568991214 | Rehab Medical, Inc | Durable Medical Equipment & Medical Supplies | 8568 Highway 85, Jonesboro, GA 30238 | 2017-06-07 |
| 1821472077 | Surgivue First Assisting | Nurse Practitioner | 5865 Sinclair Way, Jonesboro, GA 30238 | 2015-07-17 |
| 1518384106 | Visions of Life Behavioral Health Services, Incorporated | Counselor | 754 Chapman Street, Jonesboro, GA 30238 | 2014-03-21 |
| 1942560206 | Terri L Lee | Counselor | 7899 Waterwheel Way, Jonesboro, GA 30238 | 2012-05-21 |
| 1265704985 | Visiting Homecare Support Services, Inc. | Home Health | 10886 Tara Village Way, Jonesboro, GA 30238 | 2012-01-27 |
| 1518297175 | Heavenly Assisted Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10555 Aspenwood Ct, Jonesboro, GA 30238 | 2010-01-05 |
| 1649419821 | Carmen Melton Douglas | Speech-Language Pathologist | 10354 Shepperton Court, Jonesboro, GA 30238 | 2009-02-12 |
| 1205050259 | Caryn Ann Grzesiakowski | Chiropractor | 809 Flint River Road, Suite #4, Jonesboro, GA 30238 | 2007-04-12 |
| 1548325483 | Janet Musser Granski | Social Worker | 110 North Bend Court, Jonesboro, GA 30238 | 2006-12-22 |
| Find all providers in zip 30238 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619523925 | Tarr Personal Care Home LLC. | Community/Behavioral Health | 1180 Mundys Mill Rd, Jonesboro, GA 30238-6038 | 2019-08-13 |
| 1548741713 | Chance of Change, Inc | Community/Behavioral Health | 1489 Mundys Mill Rd Ste 200, Jonesboro, GA 30238-6026 | 2018-08-27 |
| 1255874566 | Andrew J. Nelson, LLC | Community/Behavioral Health | 741 Barnesdale Dr, Jonesboro, GA 30236-1801 | 2016-11-18 |
| 1528513538 | Building A Strong Foundation Consultant Service LLC | Community/Behavioral Health | 7301 Howard Cir, Jonesboro, GA 30236-1940 | 2016-08-19 |
| 1184045163 | Diane Johnson | Community/Behavioral Health | 1141 Gable Terrace, Jonesboro, GA 30236 | 2013-12-18 |
| 1659712180 | Business Management Consulting,llc | Community/Behavioral Health | 2469 Mead Ct, Jonesboro, GA 30236-9209 | 2013-07-12 |
| 1568806412 | Sherman Support and Solutions, LLC | Community/Behavioral Health | 259 Arrowhead Blvd Ste C1, Jonesboro, GA 30236-1167 | 2013-04-23 |
| 1023371416 | Youth Generation Inc | Community/Behavioral Health | 525 Sunnyhill Dr, Jonesboro, GA 30238-4862 | 2012-06-20 |
| 1851651426 | Tlc Family Life Center, LLC | Community/Behavioral Health | 145b N Main St, Jonesboro, GA 30236-3568 | 2012-05-16 |
| 1780957167 | Nu Beginnings | Community/Behavioral Health | 754 Chapman St, Jonesboro, GA 30238-5682 | 2012-02-16 |
| Find all providers in JONESBORO | ||||
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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.