Provider Demographics
NPI:1437699428
Name:RENEW COUNSELING, LLC
Entity Type:Organization
Organization Name:RENEW COUNSELING, LLC
Other - Org Name:RENEW COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:BESSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:502-653-7211
Mailing Address - Street 1:214 BRECKENRIDGE LN STE 114
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3868
Mailing Address - Country:US
Mailing Address - Phone:502-653-7211
Mailing Address - Fax:502-416-0723
Practice Address - Street 1:214 BRECKENRIDGE LN STE 114
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3868
Practice Address - Country:US
Practice Address - Phone:502-653-7211
Practice Address - Fax:502-416-0723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0901670251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100456570Medicaid