Organization
RENEW FAMILY ASSESSMENT GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA SHADARYN MIXON DRPH (MANAGING MEMBER)
(678) 249-8545
Entity
Organization
Contact information
Practice address
1180 MCKENDREE CHURCH RD STE 107, LAWRENCEVILLE, GA 30043-5207
(678) 249-8545
Mailing address
2041 BROOK ENCLAVE TRL, LILBURN, GA 30047-8312
(678) 249-8545
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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