Renewed Life Christian Counseling Center Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

103TP2701X Issued in DE

Legal business name

RENEWED LIFE CHRISTIAN COUNSELING CENTER INC

Practice address

3135 Summit Bridge Rd
Bear, DE 19701-2001

Phone

(302) 464-0515

Fax

(302) 454-7274

NPI assigned

Mar 6, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Grant R Hasty, LCSWNPI 1053509737

Title

Ceo/President

Phone

(302) 464-0515

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Locations

Practitioners 3

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

• Grant R Hasty, LCSW

  • Clinical Social Worker
  • Bear, DE
  • NPI 1053509737
  Medicare reassignment Care Compare group NPD Authorized official
• Ruth A Burton, LCSW

  • Clinical Social Worker
  • Bear, DE
  • NPI 1972898641
  Medicare reassignment Care Compare group NPD
• Stacey Fedale

  • Mental Health Counselor
  • Wilmington, DE
  • NPI 1275380578
  NPD

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1598039794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 DALTON DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197022059",
            "telephone_number": "302-464-0515",
            "fax_number": "302-454-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 SUMMIT BRIDGE RD",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197012001",
            "telephone_number": "302-464-0515",
            "fax_number": "302-454-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED LIFE CHRISTIAN COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-06",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "HASTY",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "302-464-0515",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "DE",
            "license": "103TP2701X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972520534",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000035733",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reliance Healthcare, LLC
• Reliance Urgent Care LLC
• Reliance Walk in Medical, LLC
• Relianceaco LLC
• Renewed Life Christian Counseling Center (Rlccc)
• Emily Catherine Reshetar, COTA/L
• Revive & Relax
• Colin Daniel Rice, DMD
• Emma L Richardson, M.A., CCC-SLP
• Michaela Riddle

• Community/Behavioral Health Agency in Bear, DE
• Providers in Bear, DE by specialty
• Community/Behavioral Health Agency in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.