Organization Active NPI

Renew Therapeutic Solutions, PLLC

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1902362502
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
RENEW THERAPEUTIC SOLUTIONS, PLLC
Practice address
5340 Plymouth Rd Ste 110
Ann Arbor, MI 48105-9558
Phone
(734) 335-4747
NPI assigned
Feb 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Roxann Mudry, LMSWNPI 1861875817
Title
Owner
Phone
(734) 335-4747

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

5340 Plymouth Rd Ste 110
Ann Arbor, MI 48105-9558

Mailing address

2163 Martin St
Westland, MI 48186-9393
Phone (734) 335-4747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190409000849 MI Part B Supplier - Clinic/Group Practice 0749521342 Receives reassigned benefits from 3 practitioners
Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory

Locations

120 E Liberty St
Ste 210
Ann Arbor, MI 48104
Phone (734) 335-4747

Practitioners & affiliated clinicians

Practitioners 3

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": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1902362502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2163 MARTIN ST",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481869393",
            "telephone_number": "734-335-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 PLYMOUTH RD STE 110",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059558",
            "telephone_number": "734-335-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW THERAPEUTIC SOLUTIONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "MUDRY",
        "authorized_official_first_name": "ROXANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-335-4747",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.