Renewed Therapy & Wellness Center LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

RENEWED THERAPY & WELLNESS CENTER LLC

Practice address

12712 W Lake Houston Pkwy Ste B4136
Houston, TX 77044-6467

Phone

(850) 625-1788

NPI assigned

Mar 27, 2023

Organization subpart

No

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

Authorized official

Name

Wajahatuddin Macci

Title

Director

Phone

(773) 817-5928

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1639873565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 N WOOD DALE RD STE 201A",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911578",
            "telephone_number": "773-817-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12712 W LAKE HOUSTON PKWY STE B4136",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770446467",
            "telephone_number": "850-625-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED THERAPY & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "MACCI",
        "authorized_official_first_name": "WAJAHATUDDIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-817-5928"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.