Provider Demographics
NPI:1982119681
Name:RESTORATION & NEW BEGINNINGS, LLC
Entity Type:Organization
Organization Name:RESTORATION & NEW BEGINNINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:470-629-5424
Mailing Address - Street 1:434 LAKE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-5800
Mailing Address - Country:US
Mailing Address - Phone:404-368-0702
Mailing Address - Fax:
Practice Address - Street 1:111 PETROL PT STE G
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1573
Practice Address - Country:US
Practice Address - Phone:470-629-5424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
GALPC009408261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1972042091OtherINDIVIDUAL NPI
GA2.1972042091OtherINDIVIDUAL NPI #