Provider Demographics
NPI:1902872310
Name:THERANEEDS, INC
Entity Type:Organization
Organization Name:THERANEEDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:JAVONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MS-SLP
Authorized Official - Phone:770-981-4927
Mailing Address - Street 1:5107 PANOLA MILL DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-2352
Mailing Address - Country:US
Mailing Address - Phone:770-981-4927
Mailing Address - Fax:
Practice Address - Street 1:5107 PANOLA MILL DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-2352
Practice Address - Country:US
Practice Address - Phone:770-981-4927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X, 283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered283X00000XHospitalsRehabilitation Hospital