NPIMap

Organization Active NPI

Renewed Life Therapy LLC

  • Mental Health Counselor
  • Derry, NH
National Provider Identifier
1407681901
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RENEWED LIFE THERAPY LLC
Practice address
5 Tsienneto Rd Unit 85
Derry, NH 03038-1552
Phone
(508) 556-7067
NPI assigned
Sep 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Authorized official

Name
Caitlyn Mastromarino, LCMHCNPI 1033605241
Title
Owner
Phone
(508) 736-0061

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

5 Tsienneto Rd Unit 85
Derry, NH 03038-1552

Mailing address

5 Tsienneto Rd Unit 85
Derry, NH 03038-1552
Phone (508) 556-7067

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1407681901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 TSIENNETO RD UNIT 85",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381552",
            "telephone_number": "508-556-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TSIENNETO RD UNIT 85",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381552",
            "telephone_number": "508-556-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED LIFE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "MASTROMARINO",
        "authorized_official_first_name": "CAITLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-736-0061",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.