REVERE COUNSELING AND CARE MANAGEMENT LLC (NPI# 1114429412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114429412 |
| Entity Type | Organization |
| Organization Name | REVERE COUNSELING AND CARE MANAGEMENT LLC |
| Practice Address |
315 W Ponce De Leon Ave Suite 370 Decatur GA 30030 |
| Practice Telephone | 4042815422 |
| Mailing Telephone | 4042815422 |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2020-05-21 |
| Authorized Official Name | STEPHANIE LYNN ROACH (OWNER) |
| Authorized Official Telephone | 4047363793 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | CSW002619 | GA | Behavioral Health & Social Service Providers |
| Street Address |
315 W PONCE DE LEON AVE SUITE 370 |
| City | DECATUR |
| State | GA |
| Zip Code | 30030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902878853 | Sharman Dyan Colosetti | Social Worker | 315 W Ponce De Leon Ave, Suite 840, Decatur, GA 30030-2400 | 2006-02-05 |
| 1063045748 | Jacqueline Frances Conway | Counselor | 315 W Ponce De Leon Ave, Decatur, GA 30030-2400 | 2020-02-20 |
| 1821621533 | Lewis Ponzo | Counselor | 315 W Ponce De Leon Ave, Decatur, GA 30030-2400 | 2020-02-20 |
| 1689182263 | Stephanie Lynn Roach | Social Worker | 315 W Ponce De Leon Ave, Suite 370, Decatur, GA 30033 | 2018-01-17 |
| 1659804300 | Authentic Living | Counselor | 315 W Ponce De Leon Ave, Suite 835, Decatur, GA 30030-2400 | 2017-04-10 |
| 1205379773 | Katie Leikam | Social Worker | 315 W Ponce De Leon Ave, Suite 847, Decatur, GA 30030-2400 | 2016-11-30 |
| 1144680562 | Sarra Everett | Counselor | 315 W Ponce De Leon Ave, Suit 440, Decatur, GA 30030-2400 | 2016-02-26 |
| 1821495987 | Byers Psychological Services LLC | Psychologist | 315 W Ponce De Leon Ave, Suite 1051, Decatur, GA 30030-2400 | 2014-12-04 |
| 1205182151 | Rainbow Counseling & Consultation Services LLC | Psychologist | 315 W Ponce De Leon Ave, Decatur Court Ste 552, Decatur, GA 30030-2400 | 2012-07-30 |
| 1932461563 | National Youth Advocate Program | Community/Behavioral Health | 315 W Ponce De Leon Ave, Decatur, GA 30030-2400 | 2012-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386276467 | Aweh Support | Social Worker | 3498 Brycewood Dr, Decatur, GA 30034-6264 | 2020-02-06 |
| 1992342638 | Kuyom R Davenport | Social Worker | 2459 Candler Rd, Decatur, GA 30032-6400 | 2019-12-02 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1801393103 | Albert Leon Phillips Jr. | Social Worker | 2741 Glenvalley Dr, Decatur, GA 30032-4207 | 2018-04-12 |
| 1578091013 | Giovanna Farnum | Social Worker | 440 Winn Way Fl 3, Decatur, GA 30030-1715 | 2017-05-29 |
| 1124562475 | Catherine Berry Moon | Social Worker | 317 W Hill St Ste 203b, Decatur, GA 30030 | 2016-12-06 |
| 1871047720 | Breanna Kelly | Social Worker | 4026 Birchwood Cv, Decatur, GA 30034-5251 | 2016-08-09 |
| 1053791335 | Sherri Cohen | Social Worker | 255 Grant St Se, Ste 303, Decatur, AL 35601-2505 | 2015-06-02 |
| 1669875423 | Tigilayo Fadahunsi | Social Worker | 10301 Jefferson Square Ct, Decatur, GA 30030-1740 | 2014-10-07 |
| 1255733028 | Cherissa Mcconnell | Social Worker | 407 Park West Ct, Decatur, TX 76234-3264 | 2014-09-23 |
| Find all providers in DECATUR | ||||
Please comment or provide details below to improve the information on REVERE COUNSELING AND CARE MANAGEMENT LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.