Healthcare Provider Details

I. General information

NPI: 1053254698
Provider Name (Legal Business Name): RENEW THE MIND COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16791 TELLURIDE ST
BRIGHTON CO
80601-4221
US

IV. Provider business mailing address

16791 TELLURIDE ST
BRIGHTON CO
80601-4221
US

V. Phone/Fax

Practice location:
  • Phone: 303-883-1926
  • Fax:
Mailing address:
  • Phone: 303-883-1926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY LOGAN
Title or Position: COUNSELOR/OWNER
Credential: LPC
Phone: 303-883-1926