Renew Mental Health and Wellness, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RENEW MENTAL HEALTH AND WELLNESS, LLC

Practice address

1150 E Matthews Ave Ste 101a
Jonesboro, AR 72401-4356

Phone

(870) 243-0424

NPI assigned

Nov 11, 2024

Last updated

Nov 11, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

RENEW MENTAL HEALTH AND WELLNESS LLCAs reported in NPPES

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

Authorized official

Name

Autum Breckenridge

Title

Billing and Credentialing

Phone

(870) 243-3644

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Renew Mental Health and Wellness LLC

Practitioners 1

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.

• Stacey Ogletree Lynch, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jonesboro, AR
  • NPI 1750705513
  NPD (past)

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1720802341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 E MATTHEWS AVE STE 101A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014356",
            "telephone_number": "870-243-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E MATTHEWS AVE STE 101A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014356",
            "telephone_number": "870-243-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW MENTAL HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RENEW MENTAL HEALTH AND WELLNESS LLC",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "BRECKENRIDGE",
        "authorized_official_first_name": "AUTUM",
        "authorized_official_title_or_position": "BILLING AND CREDENTIALING",
        "authorized_official_telephone_number": "870-243-3644"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679724504",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitlee Reithemeyer
• Rejuvenate Nea LLC (H & S Medical & Wellness)
• Mary Keaton Render
• Renew Mental Health and Wellness LLC
• Renew Mental Health and Wellness, LLC
• Resilience Therapy, LLC
• Revitalize IV Hydration and Wellness Clinc LLC
• Revival Counseling Center
• Reviving Touch Corrective Massage, LLC
• Revolution Medical Centers PLLC

• Clinical Social Worker in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.