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INNOVATIVE THERAPY GROUP
NPI 1154193142
Clinic/Center - Mental Health (Including Community Mental Health Center) in Lithia Springs, GA

Active since October 24, 2023CLIA 11D2328192 · Waiver
690 THORNTON WAY STE A, LITHIA SPRINGS, GA 30122(678) 324-0654(678) 810-0841 Get Directions Write a Review

NPPES record last updated: October 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Innovative Therapy Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INNOVATIVE THERAPY GROUP (NPI 1154193142) is a healthcare organization registered as a mental health (including community mental health center) in Lithia Springs, Georgia and active in the NPI registry since October 2023. The organization holds a CLIA Waiver certificate valid through August 5, 2027 and lists Juan Zermeno Desantos, Program Director, as its authorized official.

NPPES Registry Identity

NPI1154193142
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameINNOVATIVE THERAPY GROUP
Location Address690 THORNTON WAY STE ALithia Springs, GA 30122-2614
Mailing Address690 Thornton Way Ste ALithia Springs, GA 30122-2614 · (678) 324-0654
Phone(678) 324-0654
Fax(678) 810-0841
Organization SubpartNo
Authorized OfficialJuan Zermeno DesantosProgram Director · (404) 290-6786
Enumeration DateOctober 24, 2023
NPPES CertifiedOctober 24, 2023
✔ NPI 1154193142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
690 THORNTON WAY STE A, Lithia Springs, GA 30122
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2328192

Innovative Therapy Group · Lithia Springs, GA
Active · expires Aug 5, 2027
CLIA Number11D2328192
Laboratory TypeCommunity Clinic
Certificate Effective DateAugust 6, 2025
Certificate Expiration DateAugust 5, 2027
Laboratory DirectorNatalie Booner
Laboratory Phone(404) 290-6786
Laboratory LocationInnovative Therapy Group690 Thornton Way, Suite A, Lithia Springs, GA 30122
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Innovative Therapy Group's NPI number?

The NPI number for Innovative Therapy Group is 1154193142. It was assigned to this organization in the NPPES registry on October 24, 2023.

Where is Innovative Therapy Group located?

Innovative Therapy Group is located at 690 Thornton Way Ste A, Lithia Springs, GA 30122. The listed phone number is (678) 324-0654.

What is Innovative Therapy Group's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Does Innovative Therapy Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2328192) is associated with this NPI, valid through August 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Innovative Therapy Group was last updated on October 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.