A Renewal Center LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

LH60528456 Issued in WA

Legal business name

A RENEWAL CENTER LLC

Practice address

401 Olympia Ave NE Ste 318
Renton, WA 98056-4117

Phone

(425) 227-0447

NPI assigned

Oct 28, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Donna Virginia Whitmire, LMHC,CDP,NCGCII/BACC

Title

Administrator,Psychotherapist

Phone

(425) 227-0447

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1457723587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 REDMOND PL NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980563988",
            "telephone_number": "425-227-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OLYMPIA AVE NE STE 318",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980564117",
            "telephone_number": "425-227-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A RENEWAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "WHITMIRE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "VIRGINIA",
        "authorized_official_title_or_position": "ADMINISTRATOR,PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "425-227-0447",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC,CDP,NCGCII/BACC"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "WA",
            "license": "LH60528456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110000273418",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Renton, WA
• Providers in Renton, WA by specialty
• Exclusive Provider Organization in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.