Healthcare Provider Details

I. General information

NPI: 1598205114
Provider Name (Legal Business Name): SHEENA GADDIS RYMER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S RIDGE DR STE 103
COPPERHILL TN
37317-5400
US

IV. Provider business mailing address

168 ROGERS ST SUITE 103
BLAIRSVILLE GA
30512-3693
US

V. Phone/Fax

Practice location:
  • Phone: 706-455-2872
  • Fax:
Mailing address:
  • Phone: 770-500-0681
  • Fax: 844-876-6931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW006893
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMSW006895
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10078
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: