Mind Renewal Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIND RENEWAL THERAPY, LLC

Practice address

3755 E State St Ste 6
Hermitage, PA 16148-3410

Phone

(724) 734-6310

NPI assigned

Sep 22, 2021

Last updated

Sep 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Marugg, LCSWNPI 1285078303

Title

President/Therapist

Phone

(724) 734-6310

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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.

• Stephanie K Marugg, LCSW

  • Clinical Social Worker
  • Hermitage, PA
  • NPI 1285078303
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1356012066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 E STATE ST STE 6",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161483410",
            "telephone_number": "724-734-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 E STATE ST STE 6",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161483410",
            "telephone_number": "724-734-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND RENEWAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "MARUGG",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRESIDENT/THERAPIST",
        "authorized_official_telephone_number": "724-734-6310",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon L Miller, DO
• Susan Kathleen Miller, PT
• Tabatha Miller, OTR/L
• Tyler Miller
• Victoria Miller
• Wayne Minton Sr., DPM
• T David Mistretta, D.C.
• Mobile Freedom LLC
• Momentum Therapeutics
• Monarch Mental Health Services, LLC

• Clinical Social Worker in Hermitage, PA
• Providers in Hermitage, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.