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General NPI Number Information
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NPI Number | 1730930439
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Entity Type | Organization
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Legal Business Name | RENEWAL & HEALING BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 03/29/2024
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Last Update Date | 03/29/2024
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Provider Practice Location Address
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Address Line | 17160 W NORTH AVE STE 201
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City | BROOKFIELD
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State | WI
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Zip | 53005-4437
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Country | US
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Telephone | 414-640-9574
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Fax |
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Provider Business Mailing Address
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Address Line | 17160 W NORTH AVE STE 201
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City | BROOKFIELD
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State | WI
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Zip | 53005-4437
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Country | US
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Telephone | 414-640-9574
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | KIMBERLY ANN GREENWALD
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Credential | LPC, SAC
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Telephone | 414-640-9574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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