Provider Demographics
NPI:1508357229
Name:RENEW COUNSELING CONSULTING AND WELLNESS SERVICES LLC
Entity Type:Organization
Organization Name:RENEW COUNSELING CONSULTING AND WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCADC,NCC,ACS
Authorized Official - Phone:732-588-8740
Mailing Address - Street 1:371 HOES LN STE 200
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4143
Mailing Address - Country:US
Mailing Address - Phone:732-588-8740
Mailing Address - Fax:855-240-7470
Practice Address - Street 1:371 HOES LN STE 200
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4143
Practice Address - Country:US
Practice Address - Phone:732-588-8740
Practice Address - Fax:855-240-7470
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RENEW COUNSELING CONSULTING AND WELLNESS SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-29
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0560715Medicaid