Healthcare Provider Details

I. General information

NPI: 1114891744
Provider Name (Legal Business Name): RENEWED MENTALITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 N CHURCH ST
MONROE NC
28112-4800
US

IV. Provider business mailing address

4633 NC 218
PEACHLAND NC
28133-9182
US

V. Phone/Fax

Practice location:
  • Phone: 704-635-7050
  • Fax:
Mailing address:
  • Phone: 704-635-7050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BILLIE ALISHA HILL
Title or Position: OWNER
Credential: LMFT
Phone: 704-221-0932