Provider Demographics
NPI:1548618903
Name:BE RENEWED COUNSELING
Entity Type:Organization
Organization Name:BE RENEWED COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SELLECK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-420-4095
Mailing Address - Street 1:342 DUQUESNE WAY
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1458
Mailing Address - Country:US
Mailing Address - Phone:412-420-4095
Mailing Address - Fax:412-749-2150
Practice Address - Street 1:342 DUQUESNE WAY
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1458
Practice Address - Country:US
Practice Address - Phone:412-420-4095
Practice Address - Fax:412-749-2150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0159951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1902886112OtherNPI