Active NPI
Deshawn Renarda Artis, LPC
- Mental Health Counselor
- Woodstock, GA
National Provider Identifier
1295357028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC011293
- Practice address
- 700 Churchill CT Ste 110
Woodstock, GA 30188-6880 - Phone
- (770) 284-9092
- NPI assigned
- May 14, 2020
- Last updated
- May 14, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC011293 | GA | Primary |
Addresses
Primary practice location
700 Churchill CT Ste 110
Woodstock, GA 30188-6880
Mailing address
2500 Shallowford Rd NE Apt 8220
Atlanta, GA 30345-1243
Phone (404) 423-7125
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC011293 | GA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thriveworks Woodstock | Current | Accepting new patients | |
| Esfahani Enterprises LLC | Mental Health | Current | Accepting new patients |
Locations
700 Churchill Ct
Ste 110
Woodstock, GA 30188
Phone (770) 284-9092
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Thriveworks
- Counseling Psychologist
- Woodstock, GA
- NPI 1457901340
Mental Health
-
- Adult Mental Health Clinic/Center
- Woodstock, GA
- NPI 1053929786
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589414400000",
"number": "1295357028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 SHALLOWFORD RD NE APT 8220",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303451243",
"telephone_number": "404-423-7125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 CHURCHILL CT STE 110",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301886880",
"telephone_number": "770-284-9092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARTIS",
"first_name": "DESHAWN",
"middle_name": "RENARDA",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-14",
"last_updated": "2020-05-14",
"certification_date": "2020-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC011293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.