{
"Npi": {
"NPI": "1124831318",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RENOVATING HOPE COUNSELING AND SPIRITUAL DIRECTION, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "555 SUN VALLEY DR STE L3",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROSWELL",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30076-5630",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-369-8957",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "555 SUN VALLEY DR STE L3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROSWELL",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30076-5630",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "404-369-8957",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/30/2025",
"LastUpdateDate": "01/30/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHOEMAKER",
"AuthorizedOfficialFirstName": "KRISTEN",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "LPC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MAED",
"AuthorizedOfficialTelephoneNumber": "843-412-0776",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM0855X",
"TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}