Healthcare Provider Details
I. General information
NPI: 1265189252
Provider Name (Legal Business Name): RENEWED PEACE AND HEALING THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2022
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2807 N PARHAM RD
HENRICO VA
23294-4410
US
IV. Provider business mailing address
3816 MORTON DR
RICHMOND VA
23223-1275
US
V. Phone/Fax
- Phone: 804-301-3854
- Fax:
- Phone: 804-301-3854
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ONZIE
LUKE
Title or Position: CO-OWNER
Credential: LPC
Phone: 804-410-1483