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SHYDA NEMATOLLAHI
NPI 1669121026
Counselor - Mental Health in Roswell, GA

Active since March 22, 2022Opted out of Medicare · through May 7, 2028
1125 PENNY LN, ROSWELL, GA 30076(833) 432-5285 Get Directions Write a Review

NPPES record last updated: March 22, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shyda Nematollahi NPPES

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

SHYDA NEMATOLLAHI (NPI 1669121026) is an individual mental health provider in Roswell, Georgia and active in the NPI registry since March 2022. She has opted out of Medicare through May 7, 2028.

NPPES Registry Identity

NPI1669121026
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSHYDA NEMATOLLAHI
Location Address1125 PENNY LNRoswell, GA 30076-3924
Mailing Address1125 Penny LnRoswell, GA 30076-3924
Phone(833) 432-5285
Sole ProprietorNo
Enumeration DateMarch 22, 2022
NPPES CertifiedMarch 22, 2022
✔ NPI 1669121026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1125 PENNY LN, Roswell, GA 30076
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Shyda Nematollahi has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 7, 2024 through May 7, 2028.

Opt-Out Effective DateMay 7, 2024
Opt-Out In Effect ThroughMay 7, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 9

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

JORDAN BECKUM
Counselor (Mental Health)
1125 PENNY LN
ROSWELL, GA 30076
Fulton County (770) 402-4952
SAYEEDA WASEEM MS, NCC
Counselor (Professional)
1125 PENNY LN
ROSWELL, GA 30076
Fulton County (833) 432-5285
KERRI OWENS GRIMSLEY
Counselor (Mental Health)
1125 PENNY LN
ROSWELL, GA 30076
Fulton County (833) 432-5285
RENA DIAMOND MS, APC, NCC, CCH
Counselor (Mental Health)
1125 PENNY LN
ROSWELL, GA 30076
Fulton County (833) 432-5285
HEATHER SUMNER ROMERO APC
Counselor (Mental Health)
1125 PENNY LN
ROSWELL, GA 30076
Fulton County (833) 432-5285
LYNETTE A SHAW
Counselor (Mental Health)
1125 PENNY LN
ROSWELL, GA 30076
Fulton County (833) 432-5285
HILLARY BOYKIN
Counselor (Professional)
1125 PENNY LN
ROSWELL, GA 30076
Fulton County (833) 432-5285
SHANNON ARPUTHARAJ MS, APC
Counselor (Mental Health)
1125 PENNY LN
ROSWELL, GA 30076
Fulton County (833) 432-5285

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 Shyda Nematollahi's NPI number?

The NPI number for Shyda Nematollahi is 1669121026. It was assigned to this individual provider in the NPPES registry on March 22, 2022.

Where is Shyda Nematollahi located?

Shyda Nematollahi practices at 1125 Penny Ln, Roswell, GA 30076. The listed phone number is (833) 432-5285.

What is Shyda Nematollahi's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Shyda Nematollahi enrolled in Medicare?

No. Shyda Nematollahi has opted out of Medicare through May 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Shyda Nematollahi was last updated on March 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.