Renewed Mental Health Senior Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RENEWED MENTAL HEALTH SENIOR SERVICES, LLC

Practice address

5950 Live Oak Pkwy Ste 240
Norcross, GA 30093-1743

Phone

(951) 858-3598

Fax

(770) 461-0507

NPI assigned

Apr 22, 2019

Last updated

Apr 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sherian Sharomi, LCSWNPI 1972838365

Title

Ceo/Clinical Director

Phone

(951) 858-3598

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sherian Alecia Sharomi

  • Clinical Social Worker
  • Norcross, GA
  • NPI 1972838365
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1396308714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 LIVE OAK PKWY STE 240",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931743",
            "telephone_number": "951-858-3598",
            "fax_number": "770-461-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 LIVE OAK PKWY STE 240",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931743",
            "telephone_number": "951-858-3598",
            "fax_number": "770-461-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED MENTAL HEALTH SENIOR SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "SHAROMI",
        "authorized_official_first_name": "SHERIAN",
        "authorized_official_title_or_position": "CEO/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "951-858-3598",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Norcross, GA
• Providers in Norcross, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.