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General NPI Number Information
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NPI Number | 1316825110
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Entity Type | Organization
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Legal Business Name | RENEWED COUNSELING, LLC
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 2232 BROADWAY ST
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City | PADUCAH
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State | KY
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Zip | 42001-7112
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Country | US
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Telephone | 270-449-1601
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Fax | 270-220-0594
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Provider Business Mailing Address
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Address Line | 4575 METROPOLIS LAKE RD
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City | WEST PADUCAH
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State | KY
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Zip | 42086-9793
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Country | US
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Telephone | 270-449-1601
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Fax | 270-220-0594
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Authorized Official
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Title or Position | OWNER
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Name | ALLISON MACK
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Credential | LPCC-S, NCC
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Telephone | 270-449-1601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral 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 | 104100000X
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Taxonomy Name | Social Worker
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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 | 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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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #6
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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 #7
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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