INNOVATIVE THERAPY GROUP
NPI 1154193142
Clinic/Center - Mental Health (Including Community Mental Health Center) in Lithia Springs, GA
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Innovative Therapy Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Innovative Therapy Group, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Lawrenceville, GA 30046
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, GAFrequently 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.
Is Innovative Therapy Group enrolled in Medicare?
Yes. Innovative Therapy Group is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Innovative Therapy Group?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Innovative Therapy Group, in Clinical Social Worker, Nurse Practitioner and Psychiatry. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 3 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.
# Innovative Therapy Group · NPI 1154193142
Mental Health (Including Community Mental Health Center) organization in Lithia Springs, Georgia. Organization record, active in the CMS NPPES registry since October 24, 2023.
## Identity
- **NPI:** 1154193142 (Entity type: Organization)
- **Enumerated:** October 24, 2023
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Juan Zermeno Desantos, PROGRAM DIRECTOR
## Practice location
- **Address:** 690 THORNTON WAY STE A, Lithia Springs, GA 30122-2614
- **Phone:** (678) 324-0654 · **Fax:** (678) 810-0841
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (1), Nurse Practitioner (1), Psychiatry (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 24, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1154193142) · Data from the CMS NPPES public registry.