Provider Demographics
NPI:1477696532
Name:SHALLCROSS, JOHN POST (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:POST
Last Name:SHALLCROSS
Suffix:
Gender:M
Credentials:PSYD
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Mailing Address - Street 1:1660 HIGHGROVE CLUB DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-6983
Mailing Address - Country:US
Mailing Address - Phone:770-663-0923
Mailing Address - Fax:770-663-6256
Practice Address - Street 1:11755 POINTE PL
Practice Address - Street 2:STE. A-1
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4636
Practice Address - Country:US
Practice Address - Phone:770-663-0923
Practice Address - Fax:770-663-6256
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2024-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAGA 001666103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582006242OtherTAX ID
GA00695912BMedicaid
GA00695912BMedicaid