Healthcare Provider Details

I. General information

NPI: 1689373680
Provider Name (Legal Business Name): RENAISSANCE COUNSELING AND PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12773 FOREST HILL BLVD STE 1206
WELLINGTON FL
33414-4760
US

IV. Provider business mailing address

9314 FOREST HILL BLVD STE 738
WELLINGTON FL
33411-6577
US

V. Phone/Fax

Practice location:
  • Phone: 561-425-8308
  • Fax:
Mailing address:
  • Phone: 561-425-8308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CLAUDIA ROJAS
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential: MA, CRC, LMHC
Phone: 407-590-1874