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NPI Code Detail

MEDICARE: RENEWAL COUNSELING GROUP PLLC

MEDICARE: RENEWAL COUNSELING GROUP PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1467026401
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENEWAL COUNSELING GROUP PLLC
Provider Business Mailing Address
First Line : 808 E OAK STREET UNIT 1A
Second Line :
City : LAKE IN THE HILLS
State : IL
Zip : 60156-3365
Country : US
Telephone Number : 224-326-4200
Fax Number :
Provider Business Practice Location Address
First Line : 1301 PYOTT RD STE 208A
Second Line :
City : LAKE IN THE HILLS
State : IL
Zip : 60156-9798
Country : US
Telephone Number : 224-326-4200
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MELANIE WALL
Credential : LCPC, CADC
Telephone Number : 224-326-4200
Provider Enumeration Date : 05/14/2021
Last Update Date : 06/30/2023

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Directions to “RENEWAL COUNSELING GROUP PLLC ” Practice Location

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