Provider Demographics
NPI:1467183137
Name:RENEWING OF THE MIND COUNSELING SERVICES
Entity Type:Organization
Organization Name:RENEWING OF THE MIND COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:GASTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:225-401-2255
Mailing Address - Street 1:12097 OLD HAMMOND HWY STE G1
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8679
Mailing Address - Country:US
Mailing Address - Phone:225-401-2255
Mailing Address - Fax:225-351-8925
Practice Address - Street 1:12097 OLD HAMMOND HWY STE G1
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8679
Practice Address - Country:US
Practice Address - Phone:225-401-2255
Practice Address - Fax:225-351-8925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3721503Medicaid