Provider Demographics
NPI:1235647041
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/CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:RASHIKA
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-213-2662
Mailing Address - Street 1:PO BOX 18362
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-8362
Mailing Address - Country:US
Mailing Address - Phone:804-213-2662
Mailing Address - Fax:888-855-4860
Practice Address - Street 1:4914 FITZHUGH AVE STE 101
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230
Practice Address - Country:US
Practice Address - Phone:804-213-2662
Practice Address - Fax:888-855-4860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-15
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040084921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty