RAVENS NEST FOUNDATION INC (NPI# 1578867982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578867982 |
| Entity Type | Organization |
| Organization Name | RAVENS NEST FOUNDATION INC |
| Practice Address |
3875 Austell Rd Ste 303 Austell GA 30106-1153 |
| Mailing Address |
Po Box 813683 Smyrna GA 30081-8683 |
| Practice Telephone | 7708196825 |
| Practice Fax Number | 7708196826 |
| Mailing Telephone | 6782146572 |
| Mailing Fax Number | 6782146573 |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2020-03-27 |
| Authorized Official Name | MS. SHELBY GREEN (CEO) |
| Authorized Official Telephone | 7708196825 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 171W00000X | Contractor | Other Service Providers | ||
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003111706A | 05 |
| Street Address |
3875 AUSTELL RD STE 303 |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-1153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689272676 | Brittany Rice | Social Worker | 3875 Austell Rd Ste 303, Austell, GA 30106-1153 | 2020-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851684864 | Wellstar Medical Group, LLC | Psychiatry & Neurology | 1680 Hospital South Dr, Austell, GA 30106-8110 | 2011-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205468840 | Angela Leigh Eubanks | Psychiatry & Neurology | 11 S Winston St, Reynolds, GA 31076-3200 | 2020-02-11 |
| 1265064364 | Haven Psychiatry, LLC | Psychiatry & Neurology | 5871 Glenridge Dr Ste 220, Atlanta, GA 30328-5305 | 2020-02-06 |
| 1760953434 | David S Deuser Md & Associates PC | Psychiatry & Neurology | 7 Saint Andrews Court, Brunswick, GA 31520 | 2018-12-06 |
| 1093249393 | Healing for All LLC | Psychiatry & Neurology | 3307 Sir Henry St, East Point, GA 30344-5831 | 2017-04-13 |
| 1699216416 | Abva, Inc | Psychiatry & Neurology | 4565 Rockmart Rd Se, Unit 1261, Silver Creek, GA 30173-2442 | 2017-03-13 |
| 1225436017 | Aatma Seva Health Inc | Psychiatry & Neurology | 523 Dixie St Ste 3, Carrollton, GA 30117-3870 | 2014-12-11 |
| 1619309309 | Howel William Slaughter Jr. | Psychiatry & Neurology | 40 Abington Ct Nw, Atlanta, GA 30327-1352 | 2013-08-05 |
| 1427493568 | Susan Kirsch | Psychiatry & Neurology | 7000 Peachtree Dunwoody Rd Bldg 16, Atlanta, GA 30328-1655 | 2013-05-02 |
| 1023362852 | Rivertown Psychiatry, PC | Psychiatry & Neurology | 1520 22nd Street, Columbus, GA 31901-1632 | 2012-10-31 |
| 1548550429 | Bene' Mental Wellness | Psychiatry & Neurology | 1835 Savoy Dr Ste 101, Atlanta, GA 30341-1073 | 2011-04-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.