Provider Demographics
NPI:1245091925
Name:RENEWED HOPE COUNSELING PLLC
Entity type:Organization
Organization Name:RENEWED HOPE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCP
Authorized Official - Phone:910-616-9197
Mailing Address - Street 1:40 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601-3331
Mailing Address - Country:US
Mailing Address - Phone:910-616-9197
Mailing Address - Fax:
Practice Address - Street 1:40 MAIN AVE
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3331
Practice Address - Country:US
Practice Address - Phone:910-616-9197
Practice Address - Fax:702-920-8893
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RENEWED HOPE COUNSELING PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)