NPIMap

Organization Active NPI

Renovate Counseling Services LLC

  • Mental Health Counselor
  • Bluffton, IN
National Provider Identifier
1689135279
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RENOVATE COUNSELING SERVICES LLC
Practice address
2350 S State Road 1
Bluffton, IN 46714-9698
Phone
(260) 307-5030
Fax
(260) 824-8445
NPI assigned
Mar 27, 2019
Last updated
May 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Authorized official

Name
Lane G. SanderNPI 1013334754
Title
Owner
Phone
(260) 307-5030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

2350 S State Road 1
Bluffton, IN 46714-9698

Mailing address

2350 S State Road 1
Bluffton, IN 46714-9698
Phone (260) 307-5030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201009001472 IN Part B Supplier - Clinic/Group Practice 6103246376 Receives reassigned benefits from 16 practitioners
Practice locations: Shelbyville, IN; Columbia City, IN; Huntington, IN; Fort Wayne, IN; Decatur, IN; Bluffton, IN

National Provider Directory

National Provider Directory

Locations

105 W Cherry St
Bluffton, IN 46714
Phone (260) 307-5030

2350 S State Road 1
Bluffton, IN 46714
Phone (260) 307-5030

215 E Van Buren St
Columbia City, IN 46725
Phone (260) 307-5030

915 S 11th St
Decatur, IN 46733
Phone (260) 301-3155

7722 Moeller Rd
Fort Wayne, IN 46806
Phone (260) 307-5030

1131 Etna Ave
Huntington, IN 46750
Phone (260) 307-5030

37 E Washington St
Shelbyville, IN 46176
Phone (260) 307-5030

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1689135279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 S STATE ROAD 1",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467149698",
            "telephone_number": "260-307-5030",
            "fax_number": "260-824-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 S STATE ROAD 1",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467149698",
            "telephone_number": "260-307-5030",
            "fax_number": "260-824-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOVATE COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "SANDER",
        "authorized_official_first_name": "LANE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-307-5030"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.