P Praxis·MD
● Active Type 1 · Individual

DR. Shilene Moultrie-Johnson, ED.D

Counselor·Fayetteville, GA· NPI 1285072470 · Enumerated 2013 · 12 years on NPI
Moultrie-Johnson is 1 of 78 counselor providers in Fayetteville and 1 of 7547 in Georgia.
NPI age
12 years
Enumerated 2013-06-10
Primary specialty
Counselor
Licensed in
MA
1 state
Status
Active
No deactivations on record
Last NPPES update
2013-06-10
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 7547 active counselor providers in Georgia.

NPI age
12 years
↑ 3 yr above median (9 yr)
State licenses
1 state
4% of peers hold multiple states
Subspecialties
0
19% of peers hold subspecialties

NPI lifetime · 2013 → 2026

2013-06Enumerated in NPPES
2013 2026

Where they practice

Practice location
190 Eli Run
Fayetteville, GA 302143723
📞 6783824999fax 7704614306
Mailing address
190 Eli Run
Fayetteville, GA 302143723
📞 6783824999fax 7704614306

Specialties

  • Counselor Primary
    Definition to come...
    MA license #1312032 taxonomy 101YP2500X

Identifiers

TypeValueNotes
01 (GA) TR-BFTS-1397 GEORGIA TRAINING APPROVAL:
01 (GA) 03112367967 AMERICAN HEART ASSOCIATION/ BLS INSTRUCTOR
01 (MA) 1312032 TEACHER'S LICENSE

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

Recently enumerated nearby: 2 new counselor providers have been added in Fayetteville in the last 180 days. See all →
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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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