Shawnta Dione Clarke | Conyers, GA • PECOS Search

Shawnta Dione Clarke

Counselor

Behavioral Health & Social Service Providers

1801 Saint Marlo Ct, Conyers, GA 30013-7413

PECOS Enrollment

Based on the most recent information from CMS, provider Shawnta Dione Clarke does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1073381034
Provider Type
Individual
Full Name
Clarke, Shawnta Dione
Credential
LPC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/19/2023
Last Updated
12/19/2023

Contact Information

Practice Location

1801 Saint Marlo Ct, Conyers, GA 30013-7413

Unlisted Fax

Mailing Location

1801 Saint Marlo Ct, Conyers, GA 30013-7413

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License LPC014261 Georgia