Provider Demographics
NPI:1033368733
Name:RENEWAL COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:RENEWAL COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:SHEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LCSW
Authorized Official - Phone:706-424-5888
Mailing Address - Street 1:598 S MILLEDGE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-1262
Mailing Address - Country:US
Mailing Address - Phone:706-424-5888
Mailing Address - Fax:706-543-5511
Practice Address - Street 1:598 S MILLEDGE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-1262
Practice Address - Country:US
Practice Address - Phone:706-424-5888
Practice Address - Fax:706-543-5511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty