SHIRLEY BOONE-SANFORD PH.D.
NPI 1609837616
Psychologist in Lawrenceville, GA

Active since March 29, 2006PECOS EnrolledAccepts Medicare Assignment
485 S PERRY ST, SUITE D, LAWRENCEVILLE, GA 30045(678) 205-0838(678) 205-0800 Get Directions Write a Review

NPPES record last updated: January 3, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Shirley Boone-sanford Ph.d. NPPES

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

SHIRLEY BOONE-SANFORD PH.D. (NPI 1609837616) is an individual psychologist in Lawrenceville, Georgia, licensed in Georgia (002451) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS and is a graduate of Southern Illinois University School Of Medicine (1996).

NPPES Registry Identity

NPI1609837616
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameSHIRLEY BOONE-SANFORDCredential: PH.D.
Location Address485 S PERRY ST, SUITE DLawrenceville, GA 30045-4923
Mailing AddressPo Box 2133Lawrenceville, GA 30046-2133 · (678) 205-0838 · Fax (678) 205-0800
Fax(678) 205-0800
Sole ProprietorNo
Medical School CMSSouthern Illinois University School Of MedicineGraduated 1996
Enumeration DateMarch 29, 2006
Last NPPES UpdateJanuary 3, 2008
✔ NPI 1609837616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in GA · 002451
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
485 S PERRY ST, Lawrenceville, GA 30045

Other Identifiers 1

Medicare ID-Type Unspecified68BBGCDGA

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shirley Boone-sanford Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911955034
PECOS Enrollment IDI20050106000655
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Shirley Boone-sanford reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Psychologist
485 S PERRY ST, SUITE D
Lawrenceville, GA 30045
  • Reassigned Medicare billing, Georgia enrollment
Internal Medicine
3495 PIEDMONT ROAD NE, NINE PIEDMONT CENTER
Atlanta, GA 30305
  • Reassigned Medicare billing, Georgia enrollment
  • 1,389 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

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

Psychologist
485 S PERRY ST, SUITE D
LAWRENCEVILLE, GA 30045

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shirley Boone-sanford's NPI number?

The NPI number for Shirley Boone-sanford is 1609837616. It was assigned to this individual provider in the NPPES registry on March 29, 2006.

Where is Shirley Boone-sanford located?

Shirley Boone-sanford practices at 485 S Perry St Suite D, Lawrenceville, GA 30045. The listed phone number is (678) 205-0838.

What is Shirley Boone-sanford's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Shirley Boone-sanford enrolled in Medicare?

Yes. Shirley Boone-sanford is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Shirley Boone-sanford's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shirley Boone-sanford reassigns Medicare benefits to 2 organizations: Sbs Psychological Associates (Lawrenceville, GA) and The Southeast Permanente Medical Group (Atlanta, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shirley Boone-sanford's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shirley Boone-sanford accept?

Health plans from Oscar Health list Shirley Boone-sanford as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shirley Boone-sanford was last updated on January 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.