Organization Active NPI

Renovated Wellness LLC

  • Registered Dietitian
  • Lynnfield, MA
National Provider Identifier
1861177719
Registry record updated Feb 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
RENOVATED WELLNESS LLC
Practice address
7 Kimball LN BLDG E
Lynnfield, MA 01940-2617
Phone
(781) 816-7008
Fax
(781) 816-7009
NPI assigned
Jun 19, 2023
Last updated
Feb 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2025

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

Authorized official

Name
Caroline MendesNPI 1588016927
Title
Owner
Phone
(617) 797-7206

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

7 Kimball LN BLDG E
Lynnfield, MA 01940-2617

Mailing address

7 Kimball LN BLDG C2
Lynnfield, MA 01940-2617

National Provider Directory

National Provider Directory

Locations

7 Kimball Ln
Lynnfield, MA 01940
Phone (781) 246-2315

7 Kimball Ln
Bldg C2
Lynnfield, MA 01940

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": "1687132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740182400000",
    "number": "1861177719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 KIMBALL LN BLDG C2",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019402617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 KIMBALL LN BLDG E",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019402617",
            "telephone_number": "781-816-7008",
            "fax_number": "781-816-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOVATED WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-19",
        "last_updated": "2025-02-22",
        "certification_date": "2025-02-22",
        "status": "A",
        "authorized_official_last_name": "MENDES",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-797-7206"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2025; 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.