Renew Therapy NW

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

RENEW THERAPY NW

Practice address

9400 SW Beaverton Hillsdale Hwy Ste 204
Beaverton, OR 97005-3315

Phone

(503) 446-2024

NPI assigned

Feb 14, 2022

Organization subpart

No

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

Authorized official

Name

Jennifer Ann Jim, LPCNPI 1144535162

Title

Owner

Phone

(503) 446-2024

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Renew Therapy NW LLC Other name

Electronic endpoints 1

Locations

Practitioners 1

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

• Jennifer Ann Jim

  • Professional Counselor
  • Portland, OR
  • NPI 1144535162
  NPD Authorized official

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1336894880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 SW BEAVERTON HILLSDALE HWY STE 250",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053300",
            "telephone_number": "503-446-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 SW BEAVERTON HILLSDALE HWY STE 204",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053315",
            "telephone_number": "503-446-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW THERAPY NW",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-14",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "JIM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-446-2024",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144535162",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Portland",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7412 SW Beaverton Hillsdale Hwy Ste 204",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972252168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Renew Therapy NW LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Renew Therapy NW LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Justice Lanetta Reliford
• Tracey Alice Remington, EFDA
• Remy Delplanche PC
• Renew Consulting, Inc
• Renew Functional Health
• Alecsandra Sinclair Renfroe, MS, NCC
• Sarah Rennalls
• Caroline Rentenaar, PT
• Laura Renteria, PH.D.
• Rest Mental Health LLC

• Professional Counselor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.