Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Shawna Jackson

Counselor • Tyrone, GA

Active NPI 1225531411 Individual Practitioner Female Practitioner
Practice location in NPPES

100 Glendalough Ct Ste E
Tyrone, GA 302902942

Call 7706839375 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

100 Glendalough Ct Ste E

Tyrone, GA 302902942

Telephone 7706839375

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Tyrone and Georgia

6 active clinicians are listed under Counselor with a practice address in Tyrone, GA (1,534 in Georgia).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

License # reported to NPPES GA 5228

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Career & Practice History

NPI enumerated March 14, 2018.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from April 2018 to November 2026.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1225531411
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 14, 2018
Last Update: March 14, 2018
Sole Proprietor: Yes

Mailing Address

914 Lakeside Way

Newnan, GA 302651191

Phone: 7706839375

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.