Healthcare Provider Details

I. General information

NPI: 1659235950
Provider Name (Legal Business Name): RENEWELL COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 FRIARS GRN
VALPARAISO IN
46385-7776
US

IV. Provider business mailing address

677 FRIARS GRN
VALPARAISO IN
46385-7776
US

V. Phone/Fax

Practice location:
  • Phone: 219-510-2564
  • Fax:
Mailing address:
  • Phone: 219-510-2564
  • 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: CLOE PSOMADELIS
Title or Position: CEO
Credential: LMHC
Phone: 219-510-2564