Provider Demographics
NPI:1720769904
Name:RENEWED LIFE COUNSELING
Entity Type:Organization
Organization Name:RENEWED LIFE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:STROUD
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, PLADC, MSCJ
Authorized Official - Phone:402-831-0024
Mailing Address - Street 1:3076 STEPHANOS DRIVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516
Mailing Address - Country:US
Mailing Address - Phone:402-831-0024
Mailing Address - Fax:
Practice Address - Street 1:13520 DISCOVERY DR STE 202
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3002
Practice Address - Country:US
Practice Address - Phone:402-915-8344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty