Susan L Shackelford, PHD & Associates, PA
NPI 1205976099 · Clinical Psychologist · Fayetteville, AR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Susan L Shackelford, PHD & Associates, PA is a Clinical Psychologist organization in Fayetteville, AR (NPI 1205976099).
Provider details
- NPI number
- 1205976099
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Lavonna Latta, Office Manager(479) 443-5575
- License
- 97-04P (AR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Psychology & Counseling Associates
Registry dates
- Enumerated
- 2007-02-08
- Last updated
- 2011-04-14
Frequently asked questions
- What is Susan L Shackelford, PHD & Associates, PA's NPI number?
- Susan L Shackelford, PHD & Associates, PA's National Provider Identifier (NPI) is 1205976099, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Susan L Shackelford, PHD & Associates, PA?
- Susan L Shackelford, PHD & Associates, PA is classified in the NPPES registry as Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Susan L Shackelford, PHD & Associates, PA located?
- Susan L Shackelford, PHD & Associates, PA's practice location on file with NPPES is 1 W Sunbridge Dr, Fayetteville, AR 72703-1825.
- What is Susan L Shackelford, PHD & Associates, PA's phone number?
- The practice phone number listed in the NPPES registry for Susan L Shackelford, PHD & Associates, PA is (479) 443-5575.
- Does Susan L Shackelford, PHD & Associates, PA accept Medicare?
- Susan L Shackelford, PHD & Associates, PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Susan L Shackelford, PHD & Associates, PA?
- The authorized official listed on Susan L Shackelford, PHD & Associates, PA's NPPES record is Lavonna Latta, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Susan L Shackelford, PHD & Associates, PA's NPI active?
- Yes — Susan L Shackelford, PHD & Associates, PA's NPI (1205976099) is active in the NPPES registry as of the last update on 2011-04-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.