Mind Renewal Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10538 Issued in SC

Legal business name

MIND RENEWAL SERVICES, LLC

Practice address

439 Congaree Rd
Greenville, SC 29607-2867

Phone

(864) 509-9087

Fax

(864) 509-9072

NPI assigned

Apr 15, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Brandy Thompson-Fisher, LISW-CP

Title

Clinical Social Worker

Phone

(443) 867-6663

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1447679519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 CONGAREE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072867",
            "telephone_number": "864-509-9087",
            "fax_number": "864-509-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 CONGAREE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072867",
            "telephone_number": "864-509-9087",
            "fax_number": "864-509-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND RENEWAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "THOMPSON-FISHER",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "443-867-6663",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "10538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1164",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christie B Mina, M.D.
• John Minarich
• John S. Minasi, M.D.
• Mind and Body Therapeutic Services, Inc.
• Mind Canvas, LLC
• Mindful Presence Counseling Services, LLC
• Mindful Therapy Solutions, LLC
• Mindful Upstate Counseling, LLC
• Mindwell LLC
• Jill Hancock Miner, CRNA

• Clinical Social Worker in Greenville, SC
• Providers in Greenville, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.