Rebirth Counseling and Training Center

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

REBIRTH COUNSELING AND TRAINING CENTER

Practice address

3120 S Martin St Ste 100
East Point, GA 30344-4396

Phone

(678) 705-5698

NPI assigned

Jan 10, 2012

Last updated

Mar 5, 2024By 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

Carolyn Harpe Waller, EDS.

Title

Executive Director

Phone

(404) 867-3093

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Theodore Morgan II, MD

  • Psychiatry Physician
  • Smyrna, GA
  • NPI 1861602443
  Medicare reassignment NPD
• Martin Thomas Johnson, M.D.

  • Child & Adolescent Psychiatry Physician
  • Atlanta, GA
  • NPI 1760784839
  NPD (past)
• Darrell Lee Murray Sr., M.D.

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1447250170
  NPD (past)
• Candice Stanley, LPC

  • Professional Counselor
  • Atlanta, GA
  • NPI 1306792874

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1932479755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 S MARTIN ST STE 100",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303444396",
            "telephone_number": "404-867-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 S MARTIN ST STE 100",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303444396",
            "telephone_number": "678-705-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBIRTH COUNSELING AND TRAINING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2024-03-05",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "HARPE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "404-867-3093",
        "authorized_official_credential": "EDS."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timberley Randolph
• Lindsay Ann Ratcliffe, M.ED. CCC-SLP
• Praharsha Ravindranatha Menon, MD
• Shaye Elizabeth Rawson, PA-C
• Lashandra Nichole Rease, NP
• Mary Latrelle Reese
• Regency Hospital Company of South Atlanta, LLC (Regency Hospital of South Atlanta)
• Remarkable Home Care Solutions, LLC
• Claude H. Rene-Cunningham, DNP, APN
• Quentin Lashawn Reynolds

• Community Health Clinic/Center in East Point, GA
• Providers in East Point, GA by specialty
• Community Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.