Provider Demographics
NPI:1386511483
Name:RENEW AND THRIVE LLC
Entity type:Organization
Organization Name:RENEW AND THRIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MAUGARETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERNS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:610-657-3657
Mailing Address - Street 1:1 E BROAD ST STE 130-1115
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-5913
Mailing Address - Country:US
Mailing Address - Phone:866-496-0302
Mailing Address - Fax:
Practice Address - Street 1:1 E BROAD ST STE 130-1115
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5913
Practice Address - Country:US
Practice Address - Phone:866-496-0302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)