{"npi":"1205976099","type":"NPI-2","status":"active","name":{"display":"Susan L Shackelford, PHD & Associates, PA","other":[],"organization_name":"SUSAN L SHACKELFORD, PHD & ASSOCIATES, PA","authorised_official":"Lavonna Latta"},"specialty":{"primary_taxonomy":"103TC0700X","primary_taxonomy_description":"Clinical Psychologist","slug":"clinical-psychologist","schema_org_specialty":null,"all":[{"code":"103TC0700X","description":"Clinical Psychologist","primary":true,"state":"AR","license":"97-04P"}]},"addresses":[{"purpose":"LOCATION","street_1":"1 W SUNBRIDGE DR","city":"FAYETTEVILLE","state":"AR","postal_code":"727031825","country_code":"US","phone":"4794435575","fax":"4794439554"},{"purpose":"MAILING","street_1":"1 W SUNBRIDGE DR","city":"FAYETTEVILLE","state":"AR","postal_code":"727031825","country_code":"US","phone":"4794435575","fax":"4794439554"}],"license":{"state":"AR","number":"97-04P"},"identifiers":[{"type_code":"01","label":"Other","value":"5T520","state":"AR","issuer":"BLUECROSS BLUESHIELD"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20120501000220","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"AR","pac_id":"8820071418"}]},"enumeration_date":"2007-02-08","last_updated":"2011-04-14","_meta":{"source":"NPPES","snapshot_date":"2011-04-14","doc_url":"https://findmynpi.com/api"}}