Active NPI
Renewed Mind Therapy
- Clinical Social Worker
- Bristol, CT
National Provider Identifier
1760113245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- RENEWED MIND THERAPY
- Practice address
- 38 Kelley St
Bristol, CT 06010-5715 - Phone
- (203) 535-7350
- NPI assigned
- Jun 23, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Claude Greene Jr., LCSW
- Title
- Cofounder
- Phone
- (203) 535-7350
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
38 Kelley St
Bristol, CT 06010-5715
Mailing address
565 Clark Ave Apt 75
Bristol, CT 06010-4055
Phone (203) 535-7350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008107263 | Medicaid | CT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | cgreene@renewedmindtherapy.co | Health Information Exchange (HIE) | Family Therapy Center |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655942400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655942400000",
"number": "1760113245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "565 CLARK AVE APT 75",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060104055",
"telephone_number": "203-535-7350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 KELLEY ST",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060105715",
"telephone_number": "203-535-7350"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RENEWED MIND THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-23",
"last_updated": "2022-06-23",
"certification_date": "2022-06-23",
"status": "A",
"authorized_official_last_name": "GREENE",
"authorized_official_first_name": "CLAUDE",
"authorized_official_title_or_position": "COFOUNDER",
"authorized_official_telephone_number": "203-535-7350",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008107263",
"state": "CT"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "cgreene@renewedmindtherapy.co",
"affiliation": "Y",
"affiliationName": "Family Therapy Center",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "38 Kelley St",
"city": "Bristol",
"state": "CT",
"country_code": "US",
"postal_code": "060105715",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bristol, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.