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SHANNAN MICHELLE EDWARDS PH.D.
NPI 1760851828
Psychologist - Clinical in Brookhaven, GA

Active since September 18, 2015Opted out of Medicare · through Aug 12, 2026
2924 CLAIRMONT RD NE, APARTMENT 447, BROOKHAVEN, GA 30329(770) 905-7573 Get Directions Write a Review

NPPES record last updated: September 18, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shannan Michelle Edwards Ph.d. NPPES

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

SHANNAN MICHELLE EDWARDS PH.D. (NPI 1760851828) is an individual clinical provider in Brookhaven, Georgia, licensed in Georgia (PSY003938) and active in the NPI registry since September 2015. She has opted out of Medicare through August 12, 2026.

NPPES Registry Identity

NPI1760851828
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameSHANNAN MICHELLE EDWARDSCredential: PH.D.
Location Address2924 CLAIRMONT RD NE, APARTMENT 447Brookhaven, GA 30329-1655
Mailing Address2924 Clairmont Rd Ne, Apartment 447Brookhaven, GA 30329-1655 · (770) 905-7573
Phone(770) 905-7573
Sole ProprietorNo
Enumeration DateSeptember 18, 2015
✔ NPI 1760851828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in GA · PSY003938
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2924 CLAIRMONT RD NE, Brookhaven, GA 30329
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Shannan Michelle Edwards Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 12, 2024 through August 12, 2026.

Opt-Out Effective DateAugust 12, 2024
Opt-Out In Effect ThroughAugust 12, 2026Opt-out affidavits renew automatically every two years unless cancelled

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 Shannan Edwards's NPI number?

The NPI number for Shannan Edwards is 1760851828. It was assigned to this individual provider in the NPPES registry on September 18, 2015.

Where is Shannan Edwards located?

Shannan Edwards practices at 2924 Clairmont Rd NE Apartment 447, Brookhaven, GA 30329. The listed phone number is (770) 905-7573.

What is Shannan Edwards's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Shannan Edwards enrolled in Medicare?

No. Shannan Edwards has opted out of Medicare through August 12, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Shannan Edwards was last updated on September 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.