| Renewed Mind Counseling Service | |
|
2910 49th St Vero Beach FL 32967-1275 | |
| (772) 205-5065 | |
| Not Available |
| Full Name | Renewed Mind Counseling Service |
|---|---|
| Speciality | Social Worker |
| Location | 2910 49th St, Vero Beach, Florida |
| Authorized Official Name and Position | Tracy B. Taylor (OWNER) |
| Authorized Official Contact | 7722055065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renewed Mind Counseling Service 5220 Us Highway 1 Ste 104-323 Vero Beach FL 32967-7600 Ph: () - | Renewed Mind Counseling Service 2910 49th St Vero Beach FL 32967-1275 Ph: (772) 205-5065 |
| NPI Number | 1174137517 |
|---|---|
| Provider Enumeration Date | 09/02/2020 |
| Last Update Date | 01/04/2021 |
| Certification Date | 01/04/2021 |
| Medicare PECOS PAC ID | 0547673071 |
|---|---|
| Medicare Enrollment ID | O20201230001385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174137517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tracy Bell Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386923126 PECOS PAC ID: 1456764984 Enrollment ID: I20201230001514 |
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