MEDICARE: RENEW YOUR MIND

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1902760028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEW YOUR MIND

Provider Business Mailing Address
First Line	:	6360 MARYLAND AVE
Second Line	:
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-1047
Country	:	US
Telephone Number	:	609-507-5443
Fax Number	:

Provider Business Practice Location Address
First Line	:	6360 MARYLAND AVE
Second Line	:
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-1047
Country	:	US
Telephone Number	:	609-507-5443
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JEROME GRANT
Credential	:
Telephone Number	:	609-507-5443

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “RENEW YOUR MIND ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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