Provider Demographics
NPI:1730521592
Name:A RENEWED MIND BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:A RENEWED MIND BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMTER COBB
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, CACII
Authorized Official - Phone:803-414-6700
Mailing Address - Street 1:7 CONIFER CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9569
Mailing Address - Country:US
Mailing Address - Phone:803-414-6700
Mailing Address - Fax:
Practice Address - Street 1:7 CONIFER CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9569
Practice Address - Country:US
Practice Address - Phone:803-414-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5544251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health