Renewed Light LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in West Deptford, New Jersey
1104578889- Practice location
- 1225 N Broad St Ste 1, West Deptford, NJ 08096-1203
- Phone
- 856-508-4925
- Fax
- 856-861-1216
- Last updated
- January 24, 2022
Renewed Light LLC is a healthcare organization based in West Deptford, NJ. Renewed Light LLC practices in West Deptford, NJ. The NPI Number for Renewed Light LLC is 1104578889. The current practice location address for Renewed Light LLC is 1225 N Broad St Ste 1, West Deptford, NJ 08096-1203 and can be reached out via phone at 856-508-4925 and via fax at 856-861-1216.
Provider Profile Details
- NPI Number
- 1104578889
- Provider Name
- Renewed Light LLC
- Provider Entity Type
- Organization
- Address
- 1225 N Broad St Ste 1, West Deptford, NJ 08096-1203
- Phone Number
- 856-508-4925
- Fax Number
- 856-861-1216
- Primary Taxonomy
- Clinic/Center, Mental Health (Including Community Mental Health Center) · 261QM0801X
- Organization Subpart
- No
- Authorized Official
- Nicholas Desimone, LPC, LCADC · Ceo/Owner · 856-508-4925
- Provider Enumeration Date
- January 24, 2022
- Last Update Date
- January 24, 2022
- Certification Date
- January 20, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1225 N Broad St Ste 1
West Deptford, NJ 08096-1203 - City
- West Deptford
- State
- New Jersey
- Zip
- 08096-1203
- Phone Number
- 856-508-4925
- Fax Number
- 856-861-1216
Provider Business Mailing Address Details
- Address
- 1225 N Broad St Ste 1
West Deptford, NJ 08096-1203 - City
- West Deptford
- State
- NJ
- Zip
- 08096-1203
- Phone Number
- 856-508-4925
- Fax Number
- 856-861-1216
License Information
- Taxonomy
- Clinic/Center, Mental Health (Including Community Mental Health Center) · 261QM0801X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Clinic/Center, Mental Health (Including Community Mental Health Center) providers near West Deptford, NJ
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- Miranda L Short, LPCCounselor, Mental Health · NPI 1558146407
- Abigail A MalitCounselor, Mental Health · NPI 1932814001
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Frequently Asked Questions
What is the NPI number of Renewed Light LLC?
The NPI number of Renewed Light LLC is 1104578889. It was assigned on January 24, 2022 and is currently active in the NPPES registry.
What is the specialty of Renewed Light LLC?
Renewed Light LLC is registered under the primary taxonomy Clinic/Center, Mental Health (Including Community Mental Health Center) (code 261QM0801X).
Where does Renewed Light LLC practice?
The practice location is 1225 N Broad St Ste 1, West Deptford, NJ 08096-1203. The office can be reached at 856-508-4925 (phone) or 856-861-1216 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1104578889 directly on the NPPES registry website.