Provider Demographics
NPI:1770314783
Name:RENEWED MINDS THERAPY LLC
Entity type:Organization
Organization Name:RENEWED MINDS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASTERS LIMITED PSYCHOLOGIST- OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-361-5750
Mailing Address - Street 1:6128 BECKLEY DR. NORTH
Mailing Address - Street 2:#1068
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014
Mailing Address - Country:US
Mailing Address - Phone:540-361-5750
Mailing Address - Fax:
Practice Address - Street 1:156 PINE KNOLL DR APT 1B
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-7892
Practice Address - Country:US
Practice Address - Phone:540-361-5750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty