Provider Demographics
NPI:1265941579
Name:RENEWING MINDS COUNSELING LLC
Entity type:Organization
Organization Name:RENEWING MINDS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-872-5577
Mailing Address - Street 1:969 W MAIN ST STE 2G
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2666
Mailing Address - Country:US
Mailing Address - Phone:203-525-1196
Mailing Address - Fax:844-847-7193
Practice Address - Street 1:969 W MAIN ST STE 2G
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2666
Practice Address - Country:US
Practice Address - Phone:203-872-5577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003086101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1801210554Medicaid