Renew Ahava Therapeutic Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RENEW AHAVA THERAPEUTIC SERVICES LLC

Practice address

3340 Poplar Ave Ste 205
Memphis, TN 38111-4680

Phone

(901) 513-7084

NPI assigned

Jan 18, 2022

Organization subpart

No

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

Authorized official

Name

Carmen Gray, LCSW

Title

Owner

Phone

(901) 513-7084

Specialties & licenses 1

Addresses

Practitioners 1

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

• Cynthia Luaune Poole, LMSW, LCSW

  • Clinical Social Worker
  • Bartlett, TN
  • NPI 1164802195
  NPD (past)

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1669123998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 POPLAR AVE STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381114680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 POPLAR AVE STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381114680",
            "telephone_number": "901-513-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW AHAVA THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-513-7084",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cielo Yambao Remorque II, P.T.
• Deborah Elaine Renard, PHD (PSYCHOLOGIST)
• Jordan Rolla Renard
• Renatus Professional Association
• Renee'S House of Care
• Renew and Bloom Wellness LLC
• Renewal Addiction Consultants, LLC
• Jenny Ann Reni, DO
• Ashton Reno, DDS
• Renpro Tennessee LLC

• Clinical Social Worker in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.