DR. SHANNON LACERNE HALL (NPI# 1164856373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164856373 |
| Entity Type | Individual |
| Full Name | DR. SHANNON LACERNE HALL |
| Practice Address |
2515 Tolliver Dr Ellenwood GA 30294-6228 |
| Practice Telephone | 6787947112 |
| Practice Fax Number | 4042419083 |
| Mailing Telephone | 6787947112 |
| Mailing Fax Number | 4042419083 |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2013-08-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 08137869 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386018190 | Shannon Hall | Physical Therapist | 744 S Philadelphia Blvd Ste C, Aberdeen, MD 21001-3655 | 2015-11-17 |
| 1356740070 | Shannon Hall | Behavioral Analyst | 15017 123rd Ave, Jamaica, NY 11434-2308 | 2014-08-19 |
| 1356629703 | Shannon Scott Hall | Chiropractor | 1652 Pleasant Ave, Kingsport, TN 37664-3125 | 2011-08-02 |
| 1588849632 | Shannon Elaine Hall | Mechanotherapist | 38101 S.e. Lusted Rd., Boring, OR 97009 | 2008-01-08 |
| 1205455359 | Shannon Elise Hall | Student in an Organized Health Care Education/Training Program | 4502 Medical Dr, San Antonio, TX 78229-4492 | 2020-04-09 |
| 1265960629 | Shannon Lynn Hall | Speech-Language Pathologist | 675 3rd Ave Fl 5, New York, NY 10017-5731 | 2017-05-30 |
| 1104361344 | Shannon Hall | Pharmacy Technician | 2501 Jackson Ave, Point Pleasant, WV 25550-2035 | 2016-12-26 |
| 1417310921 | Shannon Rhea Hall | Nurse Practitioner | 7500 Hugh Daniel Dr, Birmingham, AL 35242-7148 | 2016-04-01 |
| 1821338542 | Shannon Nicole Hall | Nurse Practitioner | 200 3rd Avenue West, Suite 110, Bradenton, FL 34205 | 2013-02-15 |
| 1720397839 | Shannon Hall | Social Worker | 1050 Ribaut Rd, Beaufort, SC 29902-5400 | 2010-10-07 |
| Street Address |
2515 TOLLIVER DR |
| City | ELLENWOOD |
| State | GA |
| Zip Code | 30294-6228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770124323 | Lula Varist Gholson | Counselor | Christian Counselor Ma Lou Gholson, 549 Lamar Drive, Forest Park, GA 30294 | 2019-10-04 |
| 1609428176 | Tykechia Todd | Ambulance | 3644 Caseys Cove, Ellenwood, GA 30294 | 2019-07-15 |
| 1891285243 | Ayana Aqila Thornton | Nurse Practitioner | 5654 Hosea Court, Ellenwood, GA 30294 | 2018-05-11 |
| 1346748837 | Kakethia S. Mack | Nurse Practitioner | 4124 Bosenberry Way, Ellenwood, GA 30294 | 2018-01-30 |
| 1851819312 | Tatiana Marcus | Prosthetist | 3895 Busby Mill Ct., Ellenwood, GA 30294 | 2017-09-05 |
| 1962944991 | Fairview Urgent Care, LLC | Clinic/Center | 4475 West Village Pkwy, Ellenwood, GA 30294 | 2016-11-08 |
| 1982006169 | Kristal Cure | Licensed Practical Nurse | 4057 Madiosn Court, Ellenwood, GA 30294 | 2014-09-19 |
| 1801233515 | 1st Class Learning and Performing Arts | Local Education Agency (LEA) | 5474 Platte Dr, Ellenwood, GA 30294 | 2013-06-04 |
| 1235480138 | Life Wellness Group of Atlanta | Home Delivered Meals | 145 Wilhemina Drive, Ellenwood, GA 30294 | 2012-10-02 |
| 1346548450 | William K Holley IIi | Counselor | 2732 Holly Berry Dr, Ellenwood, GA 30294 | 2011-03-14 |
| Find all providers in zip 30294 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932710159 | Karen Johnson Davis | Counselor | 3719 Micah Ct, Ellenwood, GA 30294-6224 | 2020-08-11 |
| 1417418294 | Tequila Chester | Counselor | 4818 Silverbush Ln, Ellenwood, GA 30294-6710 | 2019-03-26 |
| 1730554312 | Lenora Hawkins | Counselor | 3582 Poplar Shoals Ln, Ellenwood, GA 30294-4235 | 2015-12-07 |
| 1922262526 | Lateshia Shuvone Woodley | Counselor | 2676 Holly Berry Dr, Ellenwood, GA 30294-3997 | 2008-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144829102 | Estefania Salinas | Counselor | 1565 Benton Blvd Apt 412, Savannah, GA 31407-0408 | 2020-10-21 |
| 1225636392 | Courtney Hampton | Counselor | 1800 Wesleyan Dr Apt 95, Macon, GA 31210-1075 | 2020-10-12 |
| 1063010247 | Jeffrey Heath Williamson | Counselor | 3350 Lansbury Village Dr Apt 2, Atlanta, GA 30341-5749 | 2020-10-11 |
| 1548868730 | Dynamic Change | Counselor | 2255 Cumberland Pkwy Se Ste 240, Atlanta, GA 30339-4515 | 2020-10-11 |
| 1871191023 | Nichole Harden-gresham | Counselor | 3837 Bay Orchard Ln, Loganville, GA 30052-6611 | 2020-10-10 |
| 1497362917 | Valerie Larkin | Counselor | 139 W Ellis Rd Ste A, Griffin, GA 30223-7149 | 2020-09-29 |
| 1700493798 | Nathaniel Johnson | Counselor | 612 Beretta Dr, Grovetown, GA 30813-2198 | 2020-09-24 |
| 1346857463 | Jefferson Counseling, LLC | Counselor | 20 Lee St Ste 5, Jefferson, GA 30549-6327 | 2020-09-24 |
| 1376158360 | Two Rivers Counseling and Psychological Services, LLC | Counselor | 72 Bonnie Reed Psge, Midway, GA 31320-4925 | 2020-09-15 |
| 1861007064 | Tara Tanksley Stallings | Counselor | 1734 Jenkins St, Augusta, GA 30904-3736 | 2020-09-14 |
| Find all providers with the same taxonomy | ||||
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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.