Provider Demographics
NPI:1023849783
Name:HUBBARD, SHEMIKA S (EDD, LPC, PCS, CAC)
Entity type:Individual
Prefix:DR
First Name:SHEMIKA
Middle Name:S
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:EDD, LPC, PCS, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 LANCE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8722
Mailing Address - Country:US
Mailing Address - Phone:678-316-0623
Mailing Address - Fax:
Practice Address - Street 1:6230 SHILOH RD STE 140
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-8402
Practice Address - Country:US
Practice Address - Phone:404-951-7851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA776632101YS0200X
GALPC014981101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor