NPIMap

Organization Active NPI

Renew Therapy Associates, PLLC

  • Clinical Social Worker
  • Cary, NC
National Provider Identifier
1093171084
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005337 Issued in NC
Legal business name
RENEW THERAPY ASSOCIATES, PLLC
Practice address
455 Swiftside Dr
Suite 102
Cary, NC 27518-7200
Phone
(919) 271-8579
NPI assigned
Jan 7, 2016
Last updated
May 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda SupervilleNPI 1497822027
Title
Owner
Phone
(919) 271-8579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C005337 NC Primary

Addresses

Primary practice location

455 Swiftside Dr
Suite 102
Cary, NC 27518-7200

Mailing address

3029 Canopy Woods Dr
Apex, NC 27539-8794

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1093171084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3029 CANOPY WOODS DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275398794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SWIFTSIDE DR",
            "address_2": "SUITE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187200",
            "telephone_number": "919-271-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW THERAPY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "SUPERVILLE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-271-8579"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.