Life Renewal Newtwork

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401001490 Issued in MI

Legal business name

LIFE RENEWAL NEWTWORK

Practice address

33634 W 8 Mile Rd
Farmington Hills, MI 48335-5202

Phone

(248) 474-2763

Fax

(248) 476-4990

NPI assigned

Oct 18, 2016

Organization subpart

No

Name

Dr. Timothy Broe, PHD, MA, LPCNPI 1245486273

Title

Director

Phone

(248) 474-2763

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

• Timothy K Broe, PHD

  • Counselor
  • Farmington Hills, MI
  • NPI 1245486273

  Counselor

  NPD (past) Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 18, 2016.

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1922559665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33634 W 8 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483355202",
            "telephone_number": "248-474-2763",
            "fax_number": "248-476-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33634 W 8 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483355202",
            "telephone_number": "248-474-2763",
            "fax_number": "248-476-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE RENEWAL NEWTWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "BROE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "248-474-2763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401001490",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6401001490",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401001490",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "6401001490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Farmington Hills, MI
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.