NPIMap

Organization Active NPI

Renew Wellness Group, LLC

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1174004881
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC006062 Issued in GA
Legal business name
RENEW WELLNESS GROUP, LLC
Practice address
3915 Cascade Rd SW Ste T-145
Atlanta, GA 30331-8520
Phone
(404) 965-5848
Fax
(404) 965-5848
NPI assigned
Aug 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sarah Nyasha Pace, LPCNPI 1053588111
Title
Owner
Phone
(404) 909-4507

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X LPC006062 GA Primary

Addresses

Primary practice location

3915 Cascade Rd SW Ste T-145
Atlanta, GA 30331-8520

Mailing address

PO Box 42775
Atlanta, GA 30311-0775
Phone (404) 965-5848

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@renewwellnessgroup.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

3915 Cascade Rd SW
Ste T-92
Atlanta, GA 30331

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1174004881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42775",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303110775",
            "telephone_number": "404-965-5848",
            "fax_number": "404-965-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE T-145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318520",
            "telephone_number": "404-965-5848",
            "fax_number": "404-965-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-22",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "NYASHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-909-4507",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@renewwellnessgroup.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2414 Herring Rd SW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303116000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.