SHAWNA JACKSON (NPI# 1225531411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225531411 |
| Entity Type | Individual |
| Full Name | SHAWNA JACKSON |
| Practice Address |
100 Glendalough Ct Ste E Tyrone GA 30290-2942 |
| Mailing Address |
914 Lakeside Way Newnan GA 30265-1191 |
| Practice Telephone | 7706839375 |
| Mailing Telephone | 7706839375 |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2018-03-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 5228 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386011344 | Shawna Jackson | Nurse Practitioner | 8146 Hamilton Ave, Cincinnati, OH 45231-2324 | 2015-08-26 |
| 1194158436 | Shawna Jackson | Case Manager/Care Coordinator | 47202 Princeton Ave, Soldotna, AK 99669-8242 | 2013-08-09 |
| 1104053354 | Shawna Lynn Jackson | Audiologist | 1966 Inwood Rd., Dallas, TX 75235-7298 | 2009-06-15 |
| Street Address |
100 GLENDALOUGH CT STE E |
| City | TYRONE |
| State | GA |
| Zip Code | 30290-2942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578886545 | Melinda English Kantor | Counselor | 100 Glendalough Ct Ste E, Tyrone, GA 30290-2942 | 2010-03-05 |
| 1235780776 | Martha Bradley | Counselor | 100 Glendalough Ct Ste E, Tyrone, GA 30290-2942 | 2019-09-26 |
| 1588215354 | Toya Turner | Social Worker | 100 Glendalough Ct Ste E, Tyrone, GA 30290-2942 | 2019-09-24 |
| 1760985964 | Samanatha Pinkston | Counselor | 100 Glendalough Ct Ste E, Tyrone, GA 30290-2942 | 2018-03-14 |
| 1326541525 | Donna Wieczorek | Counselor | 100 Glendalough Ct Ste E, Tyrone, GA 30290-2942 | 2018-03-14 |
| 1356750806 | Hope H Morgan | Counselor | 100 Glendalough Ct Ste E, Tyrone, GA 30290-2942 | 2014-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407215361 | Kaitlin Lackey | Occupational Therapist | 105 Glendalough Court, Suite H, Tyrone, GA 30290 | 2016-02-19 |
| 1114211745 | Johannes Daniel Smit | Pharmacist | 525 Valleywood Drive, Tyrone, GA 30290 | 2011-05-31 |
| 1760700199 | Georgia Integrative Medicine | Preventive Medicine | 120 Milbrook Village Drive, Suite E, Tyrone, GA 30290 | 2010-05-10 |
| 1427384783 | Exelle Home Care | Home Health | 105 Silverthorn Drive, Tyrone, GA 30290 | 2009-10-21 |
| 1386884138 | Genesys Ob/gyn, LLC | Clinic/Center | 245 Greencastle Road, Tyrone, GA 30290 | 2009-03-05 |
| 1689858805 | Immediate Care Centers of Georgia, LLC | Clinic/Center | 190 Greencastle Rd., Tyrone, GA 30290 | 2007-12-24 |
| 1437212834 | Dawn M Coffman | Physician Assistant | 190 Handley Rd., Tyrone, GA 30290 | 2006-12-18 |
| 1912971805 | Jason Rex Lee | Dentist | 195 Greencastle Rd, Tyrone, GA 30290 | 2006-02-15 |
| 1053898759 | Heather Renee Ellis | Physical Therapist | 62 Carriage Oaks Dr, Tyrone, GA 30290 | 2018-07-25 |
| 1134630858 | Marjorie Yvette Elibert | Advanced Practice Midwife | 190 Handley Rd Ste A, Tyrone, GA 30290 | 2017-10-20 |
| Find all providers in zip 30290 | ||||
| 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 |
|---|---|---|---|---|
| 1659793131 | Don Wagner | Counselor | 406 Madison Ave, Tyrone, PA 16686-1240 | 2014-01-17 |
| 1619220688 | Christi Stringer | Counselor | 1318 Logan Ave, Tyrone, PA 16686-1614 | 2012-10-16 |
| 1518226109 | Trista Marie Haynes | Counselor | 1356 Pennsylvania Ave, 1st Floor, Tyrone, PA 16686-1620 | 2012-05-16 |
| 1609135334 | Dylan Tyler Nelson | Counselor | 453 Ferndale Dr, Tyrone, PA 16686-6709 | 2012-05-15 |
| 1417167495 | Sharon Ann Kimberling | Counselor | 1650 Clay Ave, Tyrone, PA 16686-2150 | 2007-05-22 |
| 1295959393 | Tamika Jenkins | Counselor | 145 Howell Rd Ste B, Tyrone, GA 30290-2036 | 2007-04-12 |
| 1760985964 | Samanatha Pinkston | Counselor | 100 Glendalough Ct Ste E, Tyrone, GA 30290-2942 | 2018-03-14 |
| 1326541525 | Donna Wieczorek | Counselor | 100 Glendalough Ct Ste E, Tyrone, GA 30290-2942 | 2018-03-14 |
| 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.