Organization Active NPI

Renew Life Counseling Services

  • Clinical Social Worker
  • Mechanicsburg, PA
National Provider Identifier
1831865435
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
RENEW LIFE COUNSELING SERVICES
Practice address
102A W Main St Ste 2
Mechanicsburg, PA 17055-6229
Phone
(717) 557-5357
NPI assigned
Aug 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
Delyara BeckerNPI 1316317050
Title
LCSW
Phone
(717) 557-5357

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

102A W Main St Ste 2
Mechanicsburg, PA 17055-6229

Mailing address

102A W Main St Ste 2
Mechanicsburg, PA 17055-6229
Phone (717) 557-5357

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL SimplePractice

National Provider Directory

National Provider Directory

Locations

102A W Main St
Ste 2
Mechanicsburg, PA 17055
Phone (717) 557-5357

Practitioners & 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": "1629676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1831865435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102A W MAIN ST STE 2",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170556229",
            "telephone_number": "717-557-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102A W MAIN ST STE 2",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170556229",
            "telephone_number": "717-557-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW LIFE COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "DELYARA",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "717-557-5357"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "address_1": "102A W Main St Ste 2",
            "city": "Mechanicsburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170556229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.