JEREMY DANIEL SHAIN (NPI# 1972114643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972114643 |
| Entity Type | Individual |
| Full Name | JEREMY DANIEL SHAIN |
| Credential | LPC |
| Practice Address |
101 Myrtle St Carrollton GA 30117-2212 |
| Practice Telephone | 4045124030 |
| Mailing Telephone | 4045124030 |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-08-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Street Address |
101 MYRTLE ST |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245867233 | Stephanie Renay Butler | Counselor | 523 Dixie St Ste A, Carrollton, GA 30117-3870 | 2020-03-27 |
| 1619513751 | Melissa Florine Cochran | Counselor | 523 Dixie St Ste B, Carrollton, GA 30117-3870 | 2019-11-25 |
| 1225556798 | Kimberly Watkins | Counselor | 2688 Us Highway 227, Carrollton, KY 41008-8030 | 2017-09-06 |
| 1053772574 | Dieula Previlon | Counselor | 1518 E Frankford Rd, Carrollton, TX 75007-5623 | 2016-03-10 |
| 1437515822 | Susan Lyn Butler | Counselor | 122 Lee St, Carrollton, GA 30117-3315 | 2016-01-14 |
| 1427420629 | Kenneth R. Mcgowan | Counselor | 523 Dixie St Ste 4, Carrollton, GA 30117-3870 | 2015-10-27 |
| 1396116687 | Lisa Duffey | Counselor | 151 Howell Rd, Carrollton, GA 30117-4220 | 2015-10-12 |
| 1881060200 | Alicia Brigham | Counselor | 4020 Huffines Blvd Ste 121, Carrollton, TX 75010-6524 | 2015-08-19 |
| 1467832378 | Olga Garcia Swan | Counselor | 4311 Harvest Hill Rd, Carrollton, TX 75010-4127 | 2015-06-05 |
| 1073906632 | Debbie Malloy | Counselor | 809 S Park St Ste 2, Carrollton, GA 30117-4423 | 2015-03-06 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
Please comment or provide details below to improve the information on JEREMY DANIEL SHAIN.
| 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.