Organization Active NPI

Edifiers

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1306428289
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
EDIFIERS
Practice address
650 Ponce de Leon Ave NE Ste 1063318T
Atlanta, GA 30308-1804
Phone
(404) 290-1667
NPI assigned
Apr 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Authorized official

Name
Ms. Sharday FieldsNPI 1245865351
Title
Owner
Phone
(404) 290-1667

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

650 Ponce de Leon Ave NE Ste 1063318T
Atlanta, GA 30308-1804

Mailing address

650 Ponce de Leon Ave NE Ste 300-1063
Atlanta, GA 30308-1804
Phone (404) 290-1667

Other practice location 1

3184 Tarian Way
Decatur, GA 30034-5574
Phone (404) 290-1667

Other names 1

  • Edifiers Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@edifiersmentalwellnessspa.com

National Provider Directory

National Provider Directory

Locations

650 Ponce de Leon Ave NE
Ste 1063318T
Atlanta, GA 30308
Phone (404) 290-1667

650 Ponce de Leon Ave NE
Ste 3001063
Atlanta, GA 30308
Phone (678) 837-6460

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": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1306428289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PONCE DE LEON AVE NE STE 300-1063",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081804",
            "telephone_number": "404-290-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 PONCE DE LEON AVE NE STE 1063318T",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081804",
            "telephone_number": "404-290-1667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3184 Tarian Way",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300345574",
            "country_code": "US",
            "telephone_number": "404-290-1667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EDIFIERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "SHARDAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-290-1667",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@edifiersmentalwellnessspa.com",
            "affiliation": "N",
            "address_1": "650 Ponce De Leon Ave NE Ste 300-1063",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303081804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Edifiers",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Edifiers",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 13, 2021; 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.