RAVENS NEST FOUNDATION INC
NPI 1578867982
Psychiatry & Neurology - Child & Adolescent Psychiatry in Austell, GA
NPI Status: Active since December 28, 2010
Contact Information
3875 AUSTELL RD STE 303
AUSTELL, GA
ZIP 30106
Phone: (770) 819-6825
Fax: (770) 819-6826
- Organization
- Psychiatry & Neurology
- Child & Adolescent Psychiatry
- Accepts Insurance
- CLIA Number: 11D2156443
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-17-2026
About RAVENS NEST FOUNDATION INC
This page provides the complete NPI Profile along with additional information for Ravens Nest Foundation Inc, a provider established in Austell, Georgia operating as a Psychiatry & Neurology, focusing in child & adolescent psychiatry . The healthcare provider is registered in the NPI registry with number 1578867982 assigned on December 2010. The practitioner's primary taxonomy code is 2084P0804X. The provider is registered as an organization and their NPI record was last updated 5 years ago. Ravens Nest Foundation Inc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Ms. Shelby Green (Ceo)
- NPI
- 1578867982
- Provider Name
- RAVENS NEST FOUNDATION INC
- Entity Type
- Organization
- Location Address
- 3875 AUSTELL RD STE 303 AUSTELL, GA 30106
- Location Phone
- (770) 819-6825
- Location Fax
- (770) 819-6826
- Mailing Address
- PO BOX 813683 SMYRNA, GA 30081
- Mailing Phone
- (678) 214-6572
- Mailing Fax
- (770) 819-6826
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-28-2010
- Last Update Date
- 03-27-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatry & Neurology Child & Adolescent Psychiatry
- Taxonomy Code
- 2084P0804X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 104100000X | Behavioral Health & Social Service Providers | Social Worker | |
| 3 | 171W00000X | Other Service Providers | Contractor | |
| 4 | 174400000X | Other Service Providers | Specialist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Complete Silver with Atrium Health - HMO
- Complete Silver with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 003111706A | MEDICAID (05) | GA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2156443
- Facility Type
- Physician Office
- Certificate Effective Date
- October 18, 2024
- Certificate Expiration Date
- October 17, 2026
- Laboratory Director
- DR. ANGELA SHANNON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Ravens Nest Foundation Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 7 | 8 | 8 | 6 | 7 | 9 | 8 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 14 | 8 | 16 | 6 | 14 | 9 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 4 + 8 + 1 + 6 + 6 + 1 + 4 + 9 + 1 + 6 + 24 = 78 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 78 = 2 | 2 | ||||||||
The NPI number 1578867982 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1548913825 | KENYA BAKER Individual | Physician Assistant | 3875 AUSTELL RD STE 303 AUSTELL, GA 30106 (770) 627-0970 |
| 1932961273 | NADISHA HUDSON RN Individual | Registered Nurse (Psychiatric/Mental Health) | 3875 AUSTELL RD STE 303 AUSTELL, GA 30106 (770) 819-6825 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1578867982, enumerated in the NPI registry as an "organization" on December 28, 2010
The provider is located at 3875 Austell Rd Ste 303 Austell, Ga 30106 and the phone number is (770) 819-6825
This medical organization specializes in Psychiatry & Neurology with taxonomy code 2084P0804X with a focus in Child & Adolescent Psychiatry
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 11D2156443 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on December 28, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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