NPIMap

Organization Active NPI

Renewed Mind Therapy LLC

  • Professional Counselor
  • Acworth, GA
National Provider Identifier
1831566611
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
003962 Issued in GA
Legal business name
RENEWED MIND THERAPY LLC
Practice address
85 Golf Crest Dr Ste 309
Acworth, GA 30101-2698
Phone
(678) 313-0469
Fax
(770) 974-2060
NPI assigned
Aug 27, 2015
Last updated
Aug 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Authorized official

Name
Carrie HandNPI 1710231410
Title
Sole Member
Phone
(678) 313-0469

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
Professional Counselor 101YP2500X 003962 GA Primary

Addresses

Primary practice location

85 Golf Crest Dr Ste 309
Acworth, GA 30101-2698

Mailing address

85 Golf Crest Dr Ste 309
Acworth, GA 30101-2698
Phone (678) 313-0469

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1831566611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 GOLF CREST DR STE 309",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012698",
            "telephone_number": "678-313-0469",
            "fax_number": "770-974-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 GOLF CREST DR STE 309",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012698",
            "telephone_number": "678-313-0469",
            "fax_number": "770-974-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED MIND THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "HAND",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "678-313-0469"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "003962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.