Organization Active NPI

Relax Relight Renew

  • Counselor
  • Viera, FL
National Provider Identifier
1821815135
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
RELAX RELIGHT RENEW
Practice address
7777 N Wickham Rd Ste 12-224
Viera, FL 32940-7976
Phone
(321) 223-8003
NPI assigned
Sep 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Lisa Trinca-PiersonNPI 1780438069
Title
Owner
Phone
(954) 483-7465

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

7777 N Wickham Rd Ste 12-224
Viera, FL 32940-7976

Mailing address

702 SW 122ND Ave
Pembroke Pines, FL 33025-5921
Phone (954) 483-7465

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260304002815 FL Part B Supplier - Clinic/Group Practice 2264914704 Receives reassigned benefits from 1 practitioner
Practice locations: Pembroke Pines, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1821815135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 122ND AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330255921",
            "telephone_number": "954-483-7465",
            "fax_number": "321-452-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 N WICKHAM RD STE 12-224",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329407976",
            "telephone_number": "321-223-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELAX RELIGHT RENEW",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "TRINCA-PIERSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-483-7465"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Viera, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.