Provider Demographics
NPI:1689211682
Name:RENEWED MIND COUNSELING AND CONSULTATION LLC
Entity Type:Organization
Organization Name:RENEWED MIND COUNSELING AND CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-278-9051
Mailing Address - Street 1:8221 SUMMA AVE STE F
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3451
Mailing Address - Country:US
Mailing Address - Phone:225-435-9392
Mailing Address - Fax:
Practice Address - Street 1:8221 SUMMA AVE STE F
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3451
Practice Address - Country:US
Practice Address - Phone:225-435-9392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty