Provider Demographics
NPI:1467080853
Name:MIND RENEWAL COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:MIND RENEWAL COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEREO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:616-558-6295
Mailing Address - Street 1:6087 LYTHAM CT
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-8990
Mailing Address - Country:US
Mailing Address - Phone:616-558-6295
Mailing Address - Fax:
Practice Address - Street 1:800 MONROE AVE NW STE 202
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1448
Practice Address - Country:US
Practice Address - Phone:616-558-6295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty