REVIVED AND RENEWED MENTAL HEALTH, LLC (NPI# 1376151969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376151969 |
| Entity Type | Organization |
| Organization Name | REVIVED AND RENEWED MENTAL HEALTH, LLC |
| Practice Address |
4400 Ambassador Caffery Pkwy Ste A167 Lafayette LA 70508-6760 |
| Practice Telephone | 3374500406 |
| Mailing Telephone | 3374500406 |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |
| Authorized Official Name | MRS. BRANDY M SKIDMORE (LCSW/OWNER) |
| Authorized Official Telephone | 3374500406 |
| Authorized Official Credential | MSW,LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
4400 AMBASSADOR CAFFERY PKWY STE A167 |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-6760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104474055 | 2nd Star Counseling | Clinic/Center | 260 S. Public Rd, Lafayette, CO 80026 | 2019-09-03 |
| 1962972117 | Williford Wellness Counseling Services, LLC | Clinic/Center | 412 Travis St Ste 214, Lafayette, LA 70503-2432 | 2018-11-30 |
| 1992272942 | Maloney Counseling LLC | Clinic/Center | 143 Ridgeway Dr Ste 121, Lafayette, LA 70503-3410 | 2018-10-29 |
| 1235640095 | Parent Partners LLC | Clinic/Center | 1304 Bertrand Dr Ste D5, Lafayette, LA 70506-9104 | 2017-10-19 |
| 1467772814 | First Counsel, LLC | Clinic/Center | 1720 Kaliste Saloom Rd, Suite C-8, Lafayette, LA 70508-6137 | 2010-06-08 |
| 1659921013 | Center for Thriving Families LLC | Clinic/Center | 114 Curran Ln Ste A-1, Lafayette, LA 70506-7222 | 2019-09-18 |
| 1215499173 | Effective Counseling Center | Clinic/Center | 701 Robley Dr Ste 137, Lafayette, LA 70503-5223 | 2019-04-01 |
| 1750864807 | Sharon Myotte | Clinic/Center | 1455 Dixon Ave, Lafayette, CO 80026-8879 | 2018-09-13 |
| 1366941155 | Acadiana Addiction Services | Clinic/Center | 218 Rue Beauregard Ste C, Lafayette, LA 70508-3284 | 2018-02-07 |
| 1649797853 | Focus Behavioral Health | Clinic/Center | 215 Rue Fountaine, Lafayette, LA 70508-5742 | 2017-08-28 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.