Healthcare Provider Details

I. General information

NPI: 1649151267
Provider Name (Legal Business Name): RENEW PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W HAMILTON ST
HOUSTON MS
38851-2209
US

IV. Provider business mailing address

105 W HAMILTON ST
HOUSTON MS
38851-2209
US

V. Phone/Fax

Practice location:
  • Phone: 662-542-3444
  • Fax:
Mailing address:
  • Phone: 662-542-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANDREA P POUNDS
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 662-542-3444