MEDICARE: SHANELLE THOMASINA SMITH LPC

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
1	101YP2500X	Professional Counselor	APC006694	GA
2	101YP2500X	Professional Counselor	LPC014204	GA

General Provider Information

NPI Number	:	1215572912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANELLE THOMASINA SMITH LPC

Provider Business Mailing Address
First Line	:	1157 BOOKER AVE SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-3605
Country	:	US
Telephone Number	:	770-238-6052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1157 BOOKER AVE SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-3605
Country	:	US
Telephone Number	:	770-238-6052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2019
Last Update Date	:	10/18/2023

Similar Medicare Providers

1487826582 — DR. BRITTANY L JENNINGS PT, DPT
Practice Location Address:

1631 RICHWOOD DR NE
ATLANTA, GA
30319-3605

Practice Phone: 678-386-4395
Practice Fax:

1972828176 — ADRYANE PHILLIPS LPC
Practice Location Address:

1919 JOHN WESLEY AVE
ATLANTA, GA
30337-3605

Practice Phone: 404-762-9190
Practice Fax: 404-762-9101

1174956924 — INFANT CONNECTIONS, LLC
Practice Location Address:

1631 RICHWOOD DR NE
ATLANTA, GA
30319-3605

Practice Phone: 678-386-4395
Practice Fax: 678-281-1796

1427877588 — THE UNICORN NURSE LLC
Practice Location Address:

3605 SHADOWOOD PKWY SE
ATLANTA, GA
30339-2307

Practice Phone: 832-329-8748
Practice Fax:

1992663827 — HEIDI FREQUAN WILLIAMS-COOPER
Practice Location Address:

900 MURPHY AVE SW
ATLANTA, GA
30310-2837

Practice Phone: 770-519-5066
Practice Fax:

1720836745 — KAMRYN NICOLE NICHOLES
Practice Location Address:

868 YORK AVE SW
ATLANTA, GA
30310-2750

Practice Phone: 404-752-1400
Practice Fax:

Directions to “ SHANELLE THOMASINA SMITH LPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.