Serenity4Life, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SERENITY4LIFE, LLC

Practice address

2316 Deer Springs Dr
Ellenwood, GA 30294-1168

Phone

(404) 391-7200

NPI assigned

Sep 10, 2019

Organization subpart

No

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

Authorized official

Name

Wanda Shaw

Title

Owner

Phone

(678) 540-1009

Specialties & licenses 4

Addresses

Practitioners 2

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

• Megan Renee Kelly, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Duluth, GA
  • NPI 1992313530
  NPD (past)
• Yeon Lee-Woodley, MS CCC-SLP

  • Speech-Language Pathologist
  • Montrose, CA
  • NPI 1770889867
  NPD (past)

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1205485463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 DEER SPRINGS DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941168",
            "telephone_number": "678-540-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 DEER SPRINGS DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941168",
            "telephone_number": "404-391-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY4LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2022-10-27",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-540-1009"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alvina C Shannon, PA-C
• Sharon Health Services LLC
• Sharon Medical Transportation LLC
• Shirley & Naomi Private Home Care Services & Transportation
• Sid'S Place Incorporated

• Speech-Language Pathologist in Ellenwood, GA
• Providers in Ellenwood, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.