Life Renewing Therapeutic Center, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH7747 Issued in FL

Legal business name

LIFE RENEWING THERAPEUTIC CENTER, INC.

Practice address

2699 Stirling Rd
Fort Lauderdale, FL 33312-6517

Phone

(954) 966-3741

NPI assigned

May 17, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Laura Marie Kubat, PHDNPI 1174709828

Title

President

Phone

(954) 336-3512

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Laura M Kubat, PHD

  • Mental Health Counselor
  • Fort Lauderdale, FL
  • NPI 1174709828
  NPD (past) Authorized official

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305590400000",
    "number": "1609169119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SW 66TH TER",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333175131",
            "telephone_number": "954-336-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 STIRLING RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126517",
            "telephone_number": "954-966-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE RENEWING THERAPEUTIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-17",
        "last_updated": "2011-05-17",
        "status": "A",
        "authorized_official_last_name": "KUBAT",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-336-3512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003104400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Lieberberg
• Anneli B. Liebig, ARNP
• Catherine Lievano
• Life at Seven Springs
• Life Extension Pharmacy Inc
• Life Tempo Acupuncture
• Lifeguide, LLC
• Lifeline Dialysis Center, LLC
• Lifeline Medical Supply, Inc
• Lifestyle by Design

• Mental Health Counselor in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.