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General NPI Number Information
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NPI Number | 1902585169
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Entity Type | Organization
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Legal Business Name | RENEWNM THERAPY, INC.
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 6330 RIVERSIDE PLAZA LN NW STE 210
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-2682
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Country | US
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Telephone | 505-207-8580
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Fax |
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Provider Business Mailing Address
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Address Line | 4801 LANG AVE NE STE 110
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4475
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Country | US
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Telephone | 505-207-8580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVE KEENE
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Credential |
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Telephone | 505-207-8580
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 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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