Renaissance Behavioral Health Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

32135 Issued in TX

Legal business name

RENAISSANCE BEHAVIORAL HEALTH SERVICES, LLC

Practice address

1101 N Little School Rd
Suite B
Arlington, TX 76017-1900

Phone

(817) 939-2376

Fax

(817) 478-4656

NPI assigned

Mar 26, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Angela D. Mitchell, PHD

Title

Licensed Psychologist/Owner

Phone

(817) 939-2376

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kimberly W Booker, PH.D.

  • Psychologist
  • Arlington, TX
  • NPI 1568542587
  NPD (past)

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1598089088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N LITTLE SCHOOL RD",
            "address_2": "SUITE B",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171900",
            "telephone_number": "817-939-2376",
            "fax_number": "817-478-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N LITTLE SCHOOL RD",
            "address_2": "SUITE B",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171900",
            "telephone_number": "817-939-2376",
            "fax_number": "817-478-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-26",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "817-939-2376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "32135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162269801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Arlington, TX
• Providers in Arlington, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.