SERENITY4LIFE, LLC (NPI# 1205485463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205485463 |
| Entity Type | Organization |
| Organization Name | SERENITY4LIFE, LLC |
| Practice Address |
2316 Deer Springs Dr Ellenwood GA 30294-1168 |
| Practice Telephone | 4043917200 |
| Mailing Telephone | 4702960718 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |
| Authorized Official Name | WANDA SHAW (OWNER) |
| Authorized Official Telephone | 4043917200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| Street Address |
2316 DEER SPRINGS DR |
| City | ELLENWOOD |
| State | GA |
| Zip Code | 30294-1168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551658 | Imani Williams | Physical Therapist | 2316 Deer Springs Dr, Ellenwood, GA 30294-1168 | 2020-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770124323 | Lula Varist Gholson | Counselor | Christian Counselor Ma Lou Gholson, 549 Lamar Drive, Forest Park, GA 30294 | 2019-10-04 |
| 1609428176 | Tykechia Todd | Ambulance | 3644 Caseys Cove, Ellenwood, GA 30294 | 2019-07-15 |
| 1891285243 | Ayana Aqila Thornton | Nurse Practitioner | 5654 Hosea Court, Ellenwood, GA 30294 | 2018-05-11 |
| 1346748837 | Kakethia S. Mack | Nurse Practitioner | 4124 Bosenberry Way, Ellenwood, GA 30294 | 2018-01-30 |
| 1851819312 | Tatiana Marcus | Prosthetist | 3895 Busby Mill Ct., Ellenwood, GA 30294 | 2017-09-05 |
| 1962944991 | Fairview Urgent Care, LLC | Clinic/Center | 4475 West Village Pkwy, Ellenwood, GA 30294 | 2016-11-08 |
| 1982006169 | Kristal Cure | Licensed Practical Nurse | 4057 Madiosn Court, Ellenwood, GA 30294 | 2014-09-19 |
| 1801233515 | 1st Class Learning and Performing Arts | Local Education Agency (LEA) | 5474 Platte Dr, Ellenwood, GA 30294 | 2013-06-04 |
| 1235480138 | Life Wellness Group of Atlanta | Home Delivered Meals | 145 Wilhemina Drive, Ellenwood, GA 30294 | 2012-10-02 |
| 1346548450 | William K Holley IIi | Counselor | 2732 Holly Berry Dr, Ellenwood, GA 30294 | 2011-03-14 |
| Find all providers in zip 30294 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720600083 | Speech Evolve Therapy Services, Limited Liability Company | Speech-Language Pathologist | 3980 Ambrose Ridge Ct, Ellenwood, GA 30294-6257 | 2020-05-10 |
| 1699335646 | Latoya Robinson | Speech-Language Pathologist | 132 Huntcliff Trl, Ellenwood, GA 30294-2596 | 2019-06-20 |
| 1356590673 | Toni Simone Richardson | Speech-Language Pathologist | 4606 Bouldercrest Rd, Ellenwood, GA 30294-3605 | 2008-09-10 |
| 1952561466 | Benita Madison | Speech-Language Pathologist | 3056 Anvil Block Rd Ste 118, Ellenwood, GA 30294-2864 | 2008-06-10 |
| 1790848901 | Lawanda Reese | Speech-Language Pathologist | 4482 S River Cv, Ellenwood, GA 30294-3281 | 2006-12-18 |
| 1093375149 | Jessica Cox | Speech-Language Pathologist | 226 Fairview Rd, Ellenwood, GA 30294-2704 | 2019-06-19 |
| 1578128286 | Toya Butler | Speech-Language Pathologist | 226 Fairview Rd, Ellenwood, GA 30294-2704 | 2019-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496484 | Tracey Samet Grant | Speech-Language Pathologist | 660 Glenairy Dr, Sandy Springs, GA 30328-4215 | 2020-10-31 |
| 1386242147 | Busy Little Bee Speech Therapy | Speech-Language Pathologist | 2 Parmenter St, Cartersville, GA 30120-2569 | 2020-10-14 |
| 1033717749 | Sullivan Mccallon Friedrich | Speech-Language Pathologist | 413 W Montgomery Cross Rd, Savannah, GA 31406-3364 | 2020-10-14 |
| 1235737313 | Morgan Wojcik | Speech-Language Pathologist | 1777 N East Expy Ne Ste 120, Brookhaven, GA 30329-2475 | 2020-10-12 |
| 1699372953 | Sarah Elise Vaughn | Speech-Language Pathologist | 925 Osburn Rd, Chickamauga, GA 30707-2847 | 2020-10-08 |
| 1871190561 | Brian Tye | Speech-Language Pathologist | 1168 Chulio Rd Se, Rome, GA 30161-4084 | 2020-10-06 |
| 1538766761 | Camille Steiden | Speech-Language Pathologist | 300 W Wieuca Rd Ne Ste 200, Atlanta, GA 30342-3352 | 2020-10-01 |
| 1689281032 | Chit Chat Pediatric Therapy LLC | Speech-Language Pathologist | 97 Carter St, Soperton, GA 30457-2752 | 2020-09-29 |
| 1962019893 | Miriam Beth Rosenberg | Speech-Language Pathologist | 3843 Sweet Magnolia Dr, Gainesville, GA 30504-5949 | 2020-09-24 |
| 1093320244 | Brittany Jamison | Speech-Language Pathologist | 180 Horizon Drive, Dahlonega, GA 30533 | 2020-09-14 |
| Find all providers with the same taxonomy | ||||
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| 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.