Ravens Nest Foundation Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

RAVENS NEST FOUNDATION INC

Practice address

1680 Mulkey Rd Ste 200
Austell, GA 30106-1364

Phone

(770) 819-6825

Fax

(770) 819-6826

NPI assigned

Dec 28, 2010

Last updated

Jan 28, 2026By 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

Ms. Shelby Green

Title

Ceo

Phone

(770) 819-6825

Specialties & licenses 12

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 13

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.

• Martin Thomas Johnson, M.D.

  • Child & Adolescent Psychiatry Physician
  • Atlanta, GA
  • NPI 1760784839
  Medicare reassignment
• Nadisha Hudson, RN

  • Psychiatric/Mental Health Registered Nurse
  • Austell, GA
  • NPI 1932961273
  NPD
• Sarah C Chapman, N.P.

  • Medical Physician Assistant
  • Taylorsville, GA
  • NPI 1477569952
  NPD (past)
• Renee' S. Cochran, NP

  • Family Nurse Practitioner
  • Cartersville, GA
  • NPI 1811978380
  NPD (past)
• Kara Gaskin, N.P.

  • Nurse Practitioner
  • Austell, GA
  • NPI 1619257672
  NPD (past)
• Afolake O Mobolaji, M.D

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1144535576
  NPD (past)
• Pamela L Peterman, NP

  • Family Nurse Practitioner
  • Cartersville, GA
  • NPI 1316928872
  NPD (past)
• Rhonda Randall, CNP

  • Primary Care Nurse Practitioner
  • Austell, GA
  • NPI 1124204235
  NPD (past)
• Brittany Rice, LCSW

  • Clinical Social Worker
  • Conyers, GA
  • NPI 1689272676
  NPD (past)
• Horace Wayne Templeton, M.D

  • Family Medicine Physician
  • Austell, GA
  • NPI 1720392947
  NPD (past)
• Raymond H Wexler, M.D.

  • Internal Medicine Physician
  • Austell, GA
  • NPI 1154487460
  NPD (past)
• Robert Peter Oristaglio, DO

  • Cardiovascular Disease Physician
  • Allentown, PA
  • NPI 1295838290
  NPD (past)

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1578867982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 MULKEY RD STE 200",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061364",
            "telephone_number": "770-819-6825",
            "fax_number": "770-819-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 MULKEY RD STE 200",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061364",
            "telephone_number": "770-819-6825",
            "fax_number": "770-819-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENS NEST FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-819-6825",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003261381A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Randle, FNP-C
• Linda Range, CNM
• Jennifer Wilkerson Ranson, D.O.
• Philip Rentz Rast, M.D.
• Raveh20 Psychiatric & Medical Specialist Inc.
• Tya Ray
• Alfonso E. Rea, M.D.
• Reach 2 Empower, Inc.
• Laura L Read, PAAA
• Ashlynn Earline Reaves

• Mental Health Clinic/Center (Including Community Mental Health Center) in Austell, GA
• Providers in Austell, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.