Restore and Renew Counseling Services LLC

Primary specialty

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

Legal business name

RESTORE AND RENEW COUNSELING SERVICES LLC

Practice address

401 Hughes Rd Ste 2
Madison, AL 35758-1144

Phone

(256) 755-4599

NPI assigned

Nov 9, 2021

Last updated

Nov 9, 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

Angela GundolffNPI 1467656769

Title

Owner

Phone

(916) 792-9444

Specialties & licenses 1

Addresses

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.

• Angela Gundolff, LMFT, CATC

  • Addiction (Substance Use Disorder) Counselor
  • Roseville, CA
  • NPI 1467656769
  NPD Authorized official

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1447916903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LAZY RIV",
            "city": "HARVEST",
            "state": "AL",
            "postal_code": "357498398",
            "telephone_number": "916-792-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HUGHES RD STE 2",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581144",
            "telephone_number": "256-755-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE AND RENEW COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "GUNDOLFF",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-792-9444"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Madison, AL
• Providers in Madison, AL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.