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General NPI Number Information
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NPI Number | 1154023992
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Entity Type | Organization
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Legal Business Name | RENEWED MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 03/17/2023
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 623 S SEMINARY ST STE 112
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City | FLORENCE
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State | AL
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Zip | 35630-5618
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Country | US
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Telephone | 256-577-3966
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Fax |
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Provider Business Mailing Address
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Address Line | 536 COUNTY ROAD 122
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City | FLORENCE
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State | AL
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Zip | 35634-3594
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Country | US
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Telephone | 256-577-3966
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MRS. ALLISON SMALLEY
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Credential | LICSW
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Telephone | 256-577-3966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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