Provider Demographics
NPI:1558244376
Name:WALVOORD, SHELBY (BS, MS)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:WALVOORD
Suffix:
Gender:F
Credentials:BS, MS
Other - Prefix:
Other - First Name:ROWAN
Other - Middle Name:
Other - Last Name:JACZKO WALVOORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS, MS
Mailing Address - Street 1:4200 NORTHSIDE PARKWAY NW
Mailing Address - Street 2:BLDG 14, SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327
Mailing Address - Country:US
Mailing Address - Phone:770-726-9589
Mailing Address - Fax:
Practice Address - Street 1:4200 NORTHSIDE PKWY NW BLDG 4
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327
Practice Address - Country:US
Practice Address - Phone:770-726-9589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health