Soldier Therapist

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SOLDIER THERAPIST

Practice address

1760 Lakes Pkwy Unit 4416
Lawrenceville, GA 30043-6194

Phone

(678) 805-7181

NPI assigned

Oct 28, 2021

Organization subpart

No

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

Authorized official

Name

Raymond Edwin Jeanes, LCSWNPI 1437511367

Title

Owner

Phone

(678) 805-7181

Specialties & licenses 1

Addresses

Other names 1

• The Soldier Therapist Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymond Edwin Jeanes, LCSW

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1437511367

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1780348458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 LAKES PKWY UNIT 4416",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436194",
            "telephone_number": "678-805-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 LAKES PKWY UNIT 4416",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436194",
            "telephone_number": "678-805-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLDIER THERAPIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A",
        "authorized_official_last_name": "JEANES",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-805-7181",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Soldier Therapist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julieta C Sobremonte, PA
• Victoria O Sodje, NURSE
• Sofa
• Adeola O Sogbamu
• Sojourn Therapy and Wellness Center
• Brittany Elizabeth Solis, M.D.
• Amelia Michelle Solomon
• Isaac Solomon, PHARM D
• Lyrica Linnae Solomon, LMFT
• Solvanta Health LLC

• All providers in Lawrenceville, GA
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.