| Renew Counseling | |
|
108 S 1st St Union City TN 38261-3802 | |
| (731) 592-1987 | |
| (731) 681-2823 |
| Full Name | Renew Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 108 S 1st St, Union City, Tennessee |
| Authorized Official Name and Position | Susan Johnson Lovelace (BILLING/CREDENTIALING) |
| Authorized Official Contact | 7314107719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Counseling Po Box 73 Union City TN 38281-0073 Ph: (731) 592-1987 | Renew Counseling 108 S 1st St Union City TN 38261-3802 Ph: (731) 592-1987 |
| NPI Number | 1144780222 |
|---|---|
| Provider Enumeration Date | 03/23/2019 |
| Last Update Date | 09/25/2019 |
| Medicare PECOS PAC ID | 4587993480 |
|---|---|
| Medicare Enrollment ID | O20190830002488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144780222 | NPI | - | NPPES |
| Q012336 | Medicaid | TN | |
| Q017284 | Medicaid | TN | |
| Q051441 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Candace Renee Eubanks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649675430 PECOS PAC ID: 8426376898 Enrollment ID: I20150415000369 |
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