NPIMap

Organization Active NPI

Renewed Life Christian Counseling Center

Doing business as Rlccc

  • Clinical Social Worker
  • Bear, DE
National Provider Identifier
1972520534
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0000765 Issued in DE
Legal business name
RENEWED LIFE CHRISTIAN COUNSELING CENTER
Doing business as
Rlccc
Practice address
3135 Summit Bridge Rd
Bear, DE 19701-2001
Phone
(302) 275-8577
Fax
(302) 454-7274
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Authorized official

Name
Mr. Grant R Hasty, LCSWNPI 1053509737
Title
Ceo/Director/Counselor
Phone
(302) 275-8577

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 MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X Q1-0000765 DE Primary

Addresses

Primary practice location

3135 Summit Bridge Rd
Bear, DE 19701-2001

Mailing address

34 Dalton Dr
Newark, DE 19702-2059

Other identifiers 2

IdentifierTypeStateIssuer
1000035733MedicaidDE
1000039721MedicaidDE

Other names 1

  • RLCCC Doing business as

National Provider Directory

National Provider Directory

Locations

1400 Red Lion Rd
Bear, DE 19701
Phone (302) 275-8577

Practitioners & affiliated clinicians

Practitioners 3

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": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305849600000",
    "number": "1972520534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 DALTON DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197022059",
            "fax_number": "302-454-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 SUMMIT BRIDGE RD",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197012001",
            "telephone_number": "302-275-8577",
            "fax_number": "302-454-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED LIFE CHRISTIAN COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-05-20",
        "status": "A",
        "authorized_official_last_name": "HASTY",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO/DIRECTOR/COUNSELOR",
        "authorized_official_telephone_number": "302-275-8577",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000035733",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000039721",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RLCCC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bear, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; 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.