Provider Demographics
NPI:1457034720
Name:RENEWED MINDS PSYCHIATRY
Entity Type:Organization
Organization Name:RENEWED MINDS PSYCHIATRY
Other - Org Name:RENEWED MINDS PSYCHIATRY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:ALELEA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-668-4246
Mailing Address - Street 1:602 CANNONS POINT LN
Mailing Address - Street 2:
Mailing Address - City:MC DANIELS
Mailing Address - State:KY
Mailing Address - Zip Code:40152-7017
Mailing Address - Country:US
Mailing Address - Phone:270-668-4246
Mailing Address - Fax:
Practice Address - Street 1:602 CANNONS POINT LN # MC
Practice Address - Street 2:
Practice Address - City:MC DANIELS
Practice Address - State:KY
Practice Address - Zip Code:40152-7017
Practice Address - Country:US
Practice Address - Phone:270-668-4246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty