Provider Demographics
NPI:1629661475
Name:RENEWING HOPE COUNSELING PLLC
Entity Type:Organization
Organization Name:RENEWING HOPE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-207-7099
Mailing Address - Street 1:2467 CAMBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-4688
Mailing Address - Country:US
Mailing Address - Phone:918-207-7099
Mailing Address - Fax:
Practice Address - Street 1:108 S MUSKOGEE AVE STE 203
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3818
Practice Address - Country:US
Practice Address - Phone:918-608-1600
Practice Address - Fax:918-608-1601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1689912560Medicaid
OK1902233604Medicaid