Renew Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RENEW COUNSELING

Practice address

108 S 1St St
Union City, TN 38261-3802

Phone

(731) 592-1987

Fax

(731) 681-2823

NPI assigned

Mar 23, 2019

Organization subpart

No

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

Authorized official

Name

Susan Johnson Lovelace

Title

Billing/Credentialing

Phone

(731) 410-7719

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Candace R Eubanks, LCSW

  • Clinical Social Worker
  • Union City, TN
  • NPI 1649675430
  Medicare reassignment NPD
• Kisha Darlene Kelly, LCSW

  • Clinical Social Worker
  • Union City, TN
  • NPI 1467006304
  NPD (past)
• Ashley Martin, APRN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Union City, TN
  • NPI 1255581799
  NPD (past)
• Kristy Anne McLaughlin, LPC/MHSP

  • Professional Counselor
  • Dyersburg, TN
  • NPI 1275673212
  NPD (past)

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

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569369600000",
    "number": "1144780222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382810073",
            "telephone_number": "731-592-1987",
            "fax_number": "731-681-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S 1ST ST",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382613802",
            "telephone_number": "731-592-1987",
            "fax_number": "731-681-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-23",
        "last_updated": "2019-09-25",
        "status": "A",
        "authorized_official_last_name": "LOVELACE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING",
        "authorized_official_telephone_number": "731-410-7719"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q012336",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q017284",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q051441",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "candace.eubanks.lcsw@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "108 S 1st St",
            "city": "Union City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "382613802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Reclaimed Mental Health Clinic, LLC
• Richard Gil Reese, DPH
• Willis Edward Reese, DDS
• Melissa Marie Reeves, APN
• Regal Pediatrics PLLC
• Bobbye Jeanne Robbins Miller, R.N.
• Lawson Roberts
• Payton Robertson
• Rodger P Lewis M D PC
• Carlos Sergio Rodriguez, DDS

• Clinical Social Worker in Union City, TN
• Providers in Union City, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.