Renew Your Mind Wellness Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

RENEW YOUR MIND WELLNESS SERVICES LLC

Practice address

5501 Twin Knolls Rd Ste 107
Columbia, MD 21045-3260

Phone

(443) 690-2272

Fax

(855) 450-1084

NPI assigned

Jan 31, 2023

Last updated

Jun 29, 2024By 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

Katia ColeyNPI 1770982241

Title

Admin/Provider

Phone

(240) 350-3015

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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.

• Katia Coley, NP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, MD
  • NPI 1770982241

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719619200000",
    "number": "1396441416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9091 SNOWDEN RIVER PKWY # 1316",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461657",
            "telephone_number": "443-690-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 TWIN KNOLLS RD STE 107",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453260",
            "telephone_number": "443-690-2272",
            "fax_number": "855-450-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW YOUR MIND WELLNESS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A",
        "authorized_official_last_name": "COLEY",
        "authorized_official_first_name": "KATIA",
        "authorized_official_title_or_position": "ADMIN/PROVIDER",
        "authorized_official_telephone_number": "240-350-3015"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tianbo Ren, MD
• Renaissance Primary Care and Wellness Group LLC
• Laura Chapman Renbaum, M.D.
• Miriam Nicole Rendon Ponce, LMSW
• Ketsia Rene
• Alex P Rennich, LCPC
• Rachel E Rentch, LCSW-C
• Rebecca Renzi
• Jessica Ann Resch, M.AC., L.AC.
• Amy Marlene Respondek, DDS

• Mental Health Clinic/Center (Including Community Mental Health Center) in Columbia, MD
• Providers in Columbia, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; 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.