Renew Your Mind

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

RENEW YOUR MIND

Practice address

21 W Main St
Waterbury, CT 06702-2013

Phone

(203) 415-8608

NPI assigned

May 9, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Shakeria C Brown, APRNNPI 1043818966

Title

Owner

Phone

(203) 415-8608

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shakeria C Brown

  • Psychiatric/Mental Health Nurse Practitioner
  • Naugatuck, CT
  • NPI 1043818966

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1851037394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HOPKINS HILL RD",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067703479",
            "telephone_number": "203-415-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022013",
            "telephone_number": "203-415-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW YOUR MIND",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SHAKERIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-415-8608",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Joseph E. Reneson, L.P.C.
• Renewing Minds Counseling LLC
• Emil Renzullo
• Restart Health and Wellness LLC
• Rebecca Restituyo, BS
• Frank Restivo, OD

• Psychiatric/Mental Health Nurse Practitioner in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.