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NPI Code Detail

MEDICARE: SHAR GOOLSBY LPCC

MEDICARE: SHAR GOOLSBY LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLPCC0022669CO
2225200000XPhysical Therapy AssistantA000863GA
3101YP2500XProfessional CounselorAPC010274GA
4225200000XPhysical Therapy Assistant2306602655VA
5225200000XPhysical Therapy AssistantPTA.00014370CO

General Provider Information

NPI Number : 1588152052
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAR GOOLSBY LPCC
Provider Business Mailing Address
First Line : 1480 NISKEY LAKE RD SW
Second Line :
City : ATLANTA
State : GA
Zip : 30331-6310
Country : US
Telephone Number : 202-631-4697
Fax Number :
Provider Business Practice Location Address
First Line : 327 DAHLONEGA ST STE A601
Second Line :
City : CUMMING
State : GA
Zip : 30040-2488
Country : US
Telephone Number : 404-590-5042
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2018
Last Update Date : 09/19/2025

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