RAVENS NEST FOUNDATION INC
NPI 1578867982
Clinic/Center - Mental Health (Including Community Mental Health Center) in Austell, GA
NPI Status: Active since December 28, 2010
Contact Information
1680 MULKEY RD STE 200
AUSTELL, GA
ZIP 30106
Phone: (770) 819-6825
Fax: (770) 819-6826
- Organization
- Clinic/Center
- Mental Health (Including Community Menta...
- CLIA Number: 11D2156443
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-17-2026
About RAVENS NEST FOUNDATION INC
This page provides the complete NPI Profile along with additional information for Ravens Nest Foundation Inc, a provider established in Austell, Georgia operating as a Clinic/center, focusing in mental health (including community mental health center) . The healthcare provider is registered in the NPI registry with number 1578867982 assigned on December 2010. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated January 2026. Ravens Nest Foundation Inc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Ms. Shelby Green (Ceo)
- NPI
- 1578867982
- Provider Name
- RAVENS NEST FOUNDATION INC
- Entity Type
- Organization
- Location Address
- 1680 MULKEY RD STE 200 AUSTELL, GA 30106
- Location Phone
- (770) 819-6825
- Location Fax
- (770) 819-6826
- Mailing Address
- 1680 MULKEY RD STE 200 AUSTELL, GA 30106
- Mailing Phone
- (770) 819-6825
- Mailing Fax
- (770) 819-6826
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-28-2010
- Last Update Date
- 01-28-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Mental Health (Including Community Mental Health Center)
- Taxonomy Code
- 261QM0801X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | |
| 3 | 104100000X | Behavioral Health & Social Service Providers | Social Worker | |
| 4 | 171W00000X | Other Service Providers | Contractor | |
| 5 | 174400000X | Other Service Providers | Specialist | |
| 6 | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | |
| 7 | 251B00000X | Agencies | Case Management | |
| 8 | 251S00000X | Agencies | Community/Behavioral Health | |
| 9 | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | |
| 10 | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | |
| 11 | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 003261381A | MEDICAID (05) | GA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2156443
- Facility Type
- Physician Office
- Certificate Effective Date
- October 18, 2024
- Certificate Expiration Date
- October 17, 2026
- Laboratory Director
- DR. ANGELA SHANNON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Ravens Nest Foundation Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1578867982, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 78. The final step is to find the difference between that total and the next multiple of ten (80 - 78 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 78 is 80. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1578867982, enumerated as an "organization" on December 28, 2010.
The provider is located at 1680 MULKEY RD STE 200 AUSTELL, GA 30106 and the phone number is (770) 819-6825.
Clinic/Center with taxonomy code 261QM0801X and a focus in Mental Health (Including Community Mental Health Center).
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
