Provider Demographics
NPI:1962860395
Name:REJUVENATE MINDS COUNSELING CENTER
Entity Type:Organization
Organization Name:REJUVENATE MINDS COUNSELING CENTER
Other - Org Name:RACHELLE JEAN-LOUIS, LMHC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-350-5073
Mailing Address - Street 1:PO BOX 15352
Mailing Address - Street 2:7580 NW 5TH ST.
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33318
Mailing Address - Country:US
Mailing Address - Phone:954-507-7219
Mailing Address - Fax:
Practice Address - Street 1:2868 NW 80TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322
Practice Address - Country:US
Practice Address - Phone:954-507-7219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-30
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10376251S00000X
FL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health