Provider Demographics
NPI:1831699685
Name:RENEW COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:RENEW COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOLONICH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:724-322-1841
Mailing Address - Street 1:91 MORGANTOWN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4233
Mailing Address - Country:US
Mailing Address - Phone:724-322-1841
Mailing Address - Fax:
Practice Address - Street 1:91 MORGANTOWN ST STE 2
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4233
Practice Address - Country:US
Practice Address - Phone:724-322-1841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004726101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty