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RAVENS NEST FOUNDATION INC
NPI 1578867982
Clinic/Center - Mental Health (Including Community Mental Health Center) in Austell, GA

Active since December 28, 2010CLIA 11D2156443 · Waiver
1680 MULKEY RD STE 200, AUSTELL, GA 30106(770) 819-6825(770) 819-6826 Get Directions Write a Review

NPPES record last updated: January 28, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 28, 2026, Dec 31, 2025, Mar 27, 2020 (3 updates tracked since 2020).

About Ravens Nest Foundation Inc NPPES

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

RAVENS NEST FOUNDATION INC (NPI 1578867982) is a healthcare organization registered as a mental health (including community mental health center) in Austell, Georgia and active in the NPI registry since December 2010. The organization holds a CLIA Waiver certificate valid through October 17, 2026 and lists Shelby Green, Ceo, as its authorized official.

NPPES Registry Identity

NPI1578867982
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameRAVENS NEST FOUNDATION INC
Location Address1680 MULKEY RD STE 200Austell, GA 30106-1364
Mailing Address1680 Mulkey Rd Ste 200Austell, GA 30106-1364 · (770) 819-6825 · Fax (770) 819-6826
Phone(770) 819-6825
Fax(770) 819-6826
Organization SubpartNo
Authorized OfficialShelby GreenCeo · (770) 819-6825
Enumeration DateDecember 28, 2010
Last NPPES UpdateJanuary 28, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 28, 2026
✔ NPI 1578867982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 12

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedSocial WorkerTaxonomy 104100000X
Also ListedContractorTaxonomy 171W00000X
Also ListedSpecialistTaxonomy 174400000X
Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X
Also ListedCase ManagementTaxonomy 251B00000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy 261QR0401X
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X
Also ListedSubstance Abuse Rehabilitation Facility · Substance Abuse Treatment, ChildrenTaxonomy 3245S0500X
1680 MULKEY RD STE 200, Austell, GA 30106
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Other Identifiers 1

Medicaid003261381AGA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 11D2156443

Ravens Nest Foundation, Inc · Austell, GA
Active · expires Oct 17, 2026
CLIA Number11D2156443
Laboratory TypePhysician Office
Certificate Effective DateOctober 18, 2024
Certificate Expiration DateOctober 17, 2026
Laboratory DirectorDr. Angela Shannon
Laboratory Phone(770) 819-6825
Laboratory LocationRavens Nest Foundation, Inc3875 Austell Road, Suite 303, Austell, GA 30106
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAVEH20 PSYCHIATRIC & MEDICAL SPECIALIST INC.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1680 MULKEY RD STE 200
AUSTELL, GA 30106
Cobb County (678) 744-2318

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 Ravens Nest Foundation Inc's NPI number?

The NPI number for Ravens Nest Foundation Inc is 1578867982. It was assigned to this organization in the NPPES registry on December 28, 2010.

Where is Ravens Nest Foundation Inc located?

Ravens Nest Foundation Inc is located at 1680 Mulkey Rd Ste 200, Austell, GA 30106. The listed phone number is (770) 819-6825.

What is Ravens Nest Foundation Inc'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 Ravens Nest Foundation Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2156443) is associated with this NPI, valid through October 17, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ravens Nest Foundation Inc was last updated on January 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.