NPIMap

Organization Active NPI

Renaissance Counseling Service Inc.

  • Psychiatry Physician
  • Brecksville, OH
National Provider Identifier
1780779793
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
RENAISSANCE COUNSELING SERVICE INC.
Practice address
5563 Woodmill Circle (Home/Business Office for Administ
Brecksville, OH 44141-1775
Phone
(440) 243-0530
Fax
(440) 237-3626
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Authorized official

Name
Abu Nasir Syed, MDNPI 1902909500
Title
President/Owner
Phone
(440) 243-0530

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5563 Woodmill Circle (Home/Business Office for Administ
Brecksville, OH 44141-1775

Mailing address

P.O. Box 598
Columbia Station, OH 44028-0598
Phone (440) 243-0530

Other identifiers 1

IdentifierTypeStateIssuer
0114521MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000506 OH Part B Supplier - Clinic/Group Practice 6204729437 Receives reassigned benefits from 2 practitioners
Practice locations: Brecksville, OH; Cleveland, OH

National Provider Directory

National Provider Directory

Locations

18820 Bagley Rd
Ste 105
Middleburg Heights, OH 44130
Phone (440) 243-0530

18820 Bagley Rd
Ste 104
Middleburg Heights, OH 44130
Phone (440) 234-4334

Practitioners & affiliated clinicians

Practitioners 12

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1780779793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 598",
            "city": "COLUMBIA STATION",
            "state": "OH",
            "postal_code": "440280598",
            "telephone_number": "440-243-0530",
            "fax_number": "440-237-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5563 WOODMILL CIRCLE (HOME/BUSINESS OFFICE FOR ADMINIST",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441411775",
            "telephone_number": "440-243-0530",
            "fax_number": "440-237-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE COUNSELING SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "SYED",
        "authorized_official_first_name": "ABU",
        "authorized_official_middle_name": "NASIR",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "440-243-0530",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114521",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brecksville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.