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MIND RENEWAL SERVICES LLC NPI 1447679519


NPI Information

NPI: 1447679519
Provider Name: MIND RENEWAL SERVICES, LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
439 CONGAREE RD
GREENVILLE, SC
ZIP 29607
Phone: (864) 509-9087
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MIND RENEWAL SERVICES, LLC is a clinical social worker in Greenville, SC. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MIND RENEWAL SERVICES, LLC NPI is 1447679519. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

439 CONGAREE RD
GREENVILLE, SC
ZIP 29607-867
Phone: (864) 509-9087
Fax: (864) 509-9072

The provider's authorized official is Brandy Thompson-fisher .
The authorized official title is Clinical Social Worker and has the following contact phone number (443) 867-6663.

The enumeration date for this NPI number is 4/15/2014 and was last updated on 4/15/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinical10538SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1SW1164MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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