NPIMap

Organization Active NPI

Life Renewal Services, Inc.

  • Mental Health Counselor
  • Windsor Mill, MD
National Provider Identifier
1124229133
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIFE RENEWAL SERVICES, INC.
Practice address
6940 Tudsbury Rd
Windsor Mill, MD 21244-2674
Phone
(410) 277-8910
Fax
(410) 277-8911
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Authorized official

Name
Mrs. Karen K Byrd, LCPC
Title
Ceo
Phone
(410) 277-8910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

6940 Tudsbury Rd
Windsor Mill, MD 21244-2674

Mailing address

6940 Tudsbury Rd
Windsor Mill, MD 21244-2674
Phone (410) 277-8910

Other identifiers 1

IdentifierTypeStateIssuer
970057900MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Life Renewal Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6940 Tudsbury Rd
Windsor Mill, MD 21244
Phone (410) 277-8910

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392681600000",
    "number": "1124229133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6940 TUDSBURY RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442674",
            "telephone_number": "410-277-8910",
            "fax_number": "410-277-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6940 TUDSBURY RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442674",
            "telephone_number": "410-277-8910",
            "fax_number": "410-277-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE RENEWAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2014-02-18",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-277-8910",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "970057900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.