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General NPI Number Information
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NPI Number | 1366945313
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Entity Type | Organization
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Legal Business Name | RENEWED VISION COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 03/15/2018
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 121 N MAIN ST
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City | SEARCY
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State | AR
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Zip | 72143-5421
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Country | US
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Telephone | 501-305-0555
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Fax | 866-350-3336
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Provider Business Mailing Address
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Address Line | 100 DOUGLAS PL
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City | SEARCY
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State | AR
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Zip | 72143-8655
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Country | US
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Telephone | 866-507-9994
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Fax | 866-350-3336
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL S JONES
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Credential |
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Telephone | 866-507-9994
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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 | P0907041
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License Number State | AR
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