Individual provider Active NPI

Sharon Nix

  • Mental Health Counselor
  • Roswell, GA
National Provider Identifier
1740722370
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
11940 Chaffin Rd
Roswell, GA 30075-1479
Phone
(404) 964-2673
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC013364 GA
Mental Health Counselor 101YM0800X GA Primary

Addresses

Primary practice location

11940 Chaffin Rd
Roswell, GA 30075-1479

Mailing address

11940 Chaffin Rd
Roswell, GA 30075-1479
Phone (404) 964-2673

Other identifiers 1

IdentifierTypeStateIssuer
LPC013364OtherGAGA LICENSE NUMBER

Other names 1

  • Sharon Ann Depeaza Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260316000940 GA Practitioner - Mental Health Counselor 9133602352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC013364GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Feb 3, 2026 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1740722370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11940 CHAFFIN RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751479",
            "telephone_number": "404-964-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11940 CHAFFIN RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751479",
            "telephone_number": "404-964-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIX",
        "first_name": "SHARON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC013364",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE NUMBER",
            "identifier": "LPC013364",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "DEPEAZA",
            "middle_name": "ANN",
            "credential": "MACMHC NCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.