Mind Renewal Transformational Centre Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MIND RENEWAL TRANSFORMATIONAL CENTRE INC

Practice address

2303 Avellino Ave
Saint Cloud, FL 34771-8010

Phone

(074) 818-9344

NPI assigned

Dec 2, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Cheryl Peats-Clarke, LMHC

Title

Ceo

Phone

(718) 300-9165

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1649817370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 BRAMBLEWOOD DR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347695038",
            "telephone_number": "407-922-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 AVELLINO AVE",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347718010",
            "telephone_number": "074-818-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND RENEWAL TRANSFORMATIONAL CENTRE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-02",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "PEATS-CLARKE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-300-9165",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Saint Cloud, FL
• Providers in Saint Cloud, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.