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General NPI Number Information
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NPI Number | 1093201758
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Entity Type | Organization
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Legal Business Name | RENEWING MINDS, INC.
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Dates
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Enumeration Date | 07/05/2018
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Last Update Date | 12/30/2019
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Provider Practice Location Address
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Address Line | 558B DENBIGH BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23608-4240
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Country | US
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Telephone | 757-236-7401
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22413
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City | NEWPORT NEWS
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State | VA
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Zip | 23609-2413
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Country | US
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Telephone | 757-509-5007
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Fax | 757-975-8047
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROSA M JOHNSON
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Credential | LPC
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Telephone | 757-509-5007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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