Renew Counseling Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00975 Issued in IA

Legal business name

RENEW COUNSELING SERVICES, LLC

Practice address

3356 Kimball Ave
Suite 3
Waterloo, IA 50702-5700

Phone

(319) 464-2940

NPI assigned

May 28, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Bruce Alan Gregory, MA

Title

Owner

Phone

(319) 464-2940

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243468800000",
    "number": "1760617138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3356 KIMBALL AVE",
            "address_2": "SUITE 3",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025700",
            "telephone_number": "319-464-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3356 KIMBALL AVE",
            "address_2": "SUITE 3",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025700",
            "telephone_number": "319-464-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-28",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-464-2940",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "00975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.