Provider Demographics
NPI:1689245110
Name:RENEWED PURPOSE THERAPEUTIC HEALING
Entity Type:Organization
Organization Name:RENEWED PURPOSE THERAPEUTIC HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-905-7859
Mailing Address - Street 1:3617 LOCHEARN DR
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-6353
Mailing Address - Country:US
Mailing Address - Phone:410-905-7859
Mailing Address - Fax:
Practice Address - Street 1:4132 E JOPPA RD STE 110-1237
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-2272
Practice Address - Country:US
Practice Address - Phone:410-905-7859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty