Renaissance Wellness & Healing LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E0004169 Issued in OH

Legal business name

RENAISSANCE WELLNESS & HEALING LLC

Practice address

1446 Reynolds Rd Ste 301
Maumee, OH 43537-1634

Phone

(419) 340-7706

Fax

(419) 932-6657

NPI assigned

Jul 22, 2010

Last updated

Aug 10, 2022By 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

Ms. Monica Birsen, LPCCNPI 1053502674

Title

Owner

Phone

(419) 340-7706

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.

• Monica A Birsen, LPCC-S

  • Counselor
  • Maumee, OH
  • NPI 1053502674
  NPD Authorized official

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1508179359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 REYNOLDS RD STE 301",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371634",
            "telephone_number": "419-340-7706",
            "fax_number": "419-932-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 REYNOLDS RD STE 301",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371634",
            "telephone_number": "419-340-7706",
            "fax_number": "419-932-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE WELLNESS & HEALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "BIRSEN",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-340-7706",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0004169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Maumee, OH
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.