Provider Demographics
NPI:1376385328
Name:RENEW YOU COUNSELING AND THERAPY CENTER PC
Entity type:Organization
Organization Name:RENEW YOU COUNSELING AND THERAPY CENTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRIAGA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-501-8596
Mailing Address - Street 1:503 N MAIN ST STE 654&656
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3130
Mailing Address - Country:US
Mailing Address - Phone:719-766-9362
Mailing Address - Fax:
Practice Address - Street 1:503 N MAIN ST STE 654&656
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3130
Practice Address - Country:US
Practice Address - Phone:719-501-8596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty