Renew a Body Mind Strategy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

SW8463 Issued in FL

Legal business name

RENEW A BODY MIND STRATEGY

Practice address

17633 Gunn Hwy # 325
Odessa, FL 33556-1912

Phone

(813) 999-0955

Fax

(813) 607-6788

NPI assigned

Aug 4, 2008

Organization subpart

No

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

Authorized official

Name

Shawn Davis, LCSW

Title

President

Phone

(813) 999-0955

Specialties & licenses 1

Addresses

Other names 1

• Shawn Davis LCSW PA Former legal business name

Locations

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1316103880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17633 GUNN HWY # 325",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335561912",
            "telephone_number": "813-999-0955",
            "fax_number": "813-607-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17633 GUNN HWY # 325",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335561912",
            "telephone_number": "813-999-0955",
            "fax_number": "813-607-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW A BODY MIND STRATEGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-999-0955",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "SW8463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawn Davis LCSW PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Shawn Davis LCSW PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Odessa, FL
• Providers in Odessa, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.