AMANDA RENEE SHACKELFORD
NPI 1386085728
Counselor - Mental Health in Sallisaw, OK

Q: What is Amanda Shackelford's NPI number?

The NPI number for Amanda Shackelford is 1386085728. It was assigned to this individual provider in the NPPES registry on July 15, 2013.

Q: What is Amanda Shackelford's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Active since July 15, 2013PECOS Enrolled

205 S J T STITES BLVD, SALLISAW, OK 74955(918) 775-7787(918) 775-0328 Get Directions Write a Review

NPPES record last updated: July 15, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Amanda Renee Shackelford NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA RENEE SHACKELFORD (NPI 1386085728) is an individual mental health provider in Sallisaw, Oklahoma and active in the NPI registry since July 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1386085728

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameAMANDA RENEE SHACKELFORD

Location Address205 S J T STITES BLVDSallisaw, OK 74955-9323

Mailing Address205 S J T Stites BlvdSallisaw, OK 74955-9323 · (918) 775-7787 · Fax (918) 775-0328

Phone(918) 775-7787

Fax(918) 775-0328

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJuly 15, 2013

✔ NPI 1386085728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

205 S J T STITES BLVD, Sallisaw, OK 74955

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Renee Shackelford is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID244655645

PECOS Enrollment IDI20200803000119

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SHARON SUE DAY CPS/BS

Counselor (Mental Health)