Provider Demographics
NPI:1033380811
Name:SHAH, SHILPA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHILPA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1899 PARKER CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3445
Mailing Address - Country:US
Mailing Address - Phone:678-987-1020
Mailing Address - Fax:678-987-1019
Practice Address - Street 1:1899 PARKER CT
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3445
Practice Address - Country:US
Practice Address - Phone:678-987-1020
Practice Address - Fax:678-987-1019
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003255101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC003255OtherLICENSED PROFESSIONAL