Organization Active NPI

Kairova Wellness Center LLC

  • Community/Behavioral Health Agency
  • Jonesboro, GA
National Provider Identifier
1285578864
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KAIROVA WELLNESS CENTER LLC
Practice address
650 Mount Zion Rd Ste a
Jonesboro, GA 30236-1560
Phone
(470) 202-0415
NPI assigned
Apr 15, 2026
Last updated
Aug 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Authorized official

Name
Shanequa Pierce
Title
Owner
Phone
(470) 202-0438

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X
Meals Provider 174200000X
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X Primary
Foster Care Agency 253J00000X
In Home Supportive Care Agency 253Z00000X
Clinic/Center 261Q00000X
Community Health Clinic/Center 261QC1500X
Prison Health Clinic/Center 261QP2400X
Rehabilitation Clinic/Center 261QR0400X
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

650 Mount Zion Rd Ste a
Jonesboro, GA 30236-1560

Mailing address

650 Mount Zion Rd Ste a
Jonesboro, GA 30236-1560

Other practice location 1

4030 Wake Forest Rd
Suite 349
Raleigh, North Carolina 27609
UM

National Provider Directory

National Provider Directory

Locations

650 Mount Zion Rd
Ste A
Jonesboro, GA 30236
Phone (470) 202-0415

NPI Registry JSON

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

{
    "created_epoch": "1776211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1285578864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 MOUNT ZION RD STE A",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 MOUNT ZION RD STE A",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361560",
            "telephone_number": "470-202-0415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 Wake Forest Rd",
            "address_2": "Suite 349",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "North Carolina",
            "postal_code": "27609",
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "organization_name": "KAIROVA WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-15",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "SHANEQUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-202-0438"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.