SHAKIRAH FORDE (NPI# 1821347154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821347154 |
| Entity Type | Individual |
| Full Name | SHAKIRAH FORDE |
| Credential | LCSW |
| Practice Address |
1770 Indian Trail Lilburn Rd Ste 120 Norcross GA 30093 |
| Mailing Address |
538 Country Lake Dr Mcdonough GA 30252-2683 |
| Practice Telephone | 6788885904 |
| Mailing Telephone | 3476340077 |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2019-11-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
CSW006433 | GA | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW006433 | GA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1345 Redmond Cir Nw, Rome, GA 301651307 | 9107429243 |
| Street Address |
1770 INDIAN TRAIL LILBURN RD STE 120 |
| City | NORCROSS |
| State | GA |
| Zip Code | 30093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517465 | Tequila Olivia Banks | Counselor | 8303 Dunleaf Arc Way Nw, Norcross, GA 30093 | 2020-10-27 |
| 1922643485 | Anthony Ervin | Case Manager/Care Coordinator | 6251 Smithpoint Dr. Bldg B, Peachtree Corners, GA 30093 | 2019-11-08 |
| 1164908885 | Marianne Altares | Speech-Language Pathologist | 1709 Oakbrook Lake Dr, Norcross, GA 30093 | 2018-07-16 |
| 1518480763 | Braces Now 14, LLC | Dentist | 4141 Steve Reynolds Blvd, Suite 2, Norcross, GA 30093 | 2017-07-19 |
| 1457802902 | Audrey Fernandes | Dentist | 4846 Jimmy Carter Blvd, Suite 203, Norcross, GA 30093 | 2016-10-19 |
| 1922456318 | Diana Lleras | Counselor | 6020 Dawson Bld Suite I, Norcross, GA 30093 | 2016-05-26 |
| 1376941500 | Katerine Velez | Counselor | 6020 Dawson Blvd., Siute I, Norcross, GA 30093 | 2014-12-22 |
| 1679979017 | Allison Ballay Donnelly | Speech-Language Pathologist | 1626 Jeurgens Ct., Norcross, GA 30093 | 2014-11-12 |
| 1588913701 | Sunrise Pharmacy | Pharmacy | 1235 Indian Trail Rd, Suite 200a, Norcross, GA 30093 | 2012-09-04 |
| 1487953741 | Avala Dental Providers | Dentist | 5495 Jimmy Carter Blvd., Suite A-14, Norcross, GA 30093 | 2011-03-24 |
| Find all providers in zip 30093 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443304 | Holly Stuckey | Social Worker | 5748 Pine Oak Dr, Norcross, GA 30092-3508 | 2020-10-04 |
| 1225652829 | Alexis Brown | Social Worker | 1182 Jenny Lyn Dr, Norcross, GA 30093-4823 | 2020-05-31 |
| 1386275964 | Psych Connection LLC | Social Worker | 2030 Beaver Ruin Rd Ste C, Norcross, GA 30071-3710 | 2020-01-31 |
| 1396308714 | Renewed Mental Health Senior Services | Social Worker | 5950 Live Oak Pkwy Ste 240, Norcross, GA 30093-1743 | 2019-04-22 |
| 1578028676 | Shari S Grizzle | Social Worker | 2030 Beaver Ruin Rd, Norcross, GA 30071-3710 | 2019-02-04 |
| 1316344864 | Abria J Bonner | Social Worker | 6900 Springs Ln, Apt E, Norcross, GA 30092-6547 | 2014-11-28 |
| 1558619833 | Lisa Ann Sackellares | Social Worker | 6000 Live Oak Pkwy, Suite 100, Norcross, GA 30093-1732 | 2012-08-17 |
| 1932465697 | Brandy Shavon Stinson | Social Worker | 4345 Redgate Rd, Norcross, GA 30093-3313 | 2012-04-07 |
| 1730408543 | Suzanne Wunder Timms | Social Worker | 4530 S Berkeley Lake Rd # B, Norcross, GA 30071-1639 | 2010-05-19 |
| 1780720029 | Vivian Varner Wilber | Social Worker | 4989 Peachtree Pkwy, Suite 200, Norcross, GA 30092-2589 | 2007-01-30 |
| Find all providers in NORCROSS | ||||
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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.