Provider Demographics
NPI:1407303126
Name:RENAISSANCE WELLNESS SERVICES, LLC
Entity Type:Organization
Organization Name:RENAISSANCE WELLNESS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BARBEE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPC, LCASA, NCC
Authorized Official - Phone:919-704-8449
Mailing Address - Street 1:288 EAST ST STE 1001-F7
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-9711
Mailing Address - Country:US
Mailing Address - Phone:919-704-8449
Mailing Address - Fax:919-704-8617
Practice Address - Street 1:288 EAST ST STE 1001-F7
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312
Practice Address - Country:US
Practice Address - Phone:919-704-8449
Practice Address - Fax:919-704-8617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-10
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20589101YA0400X
NC10075101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty