| Renewed Minds, Llc | |
|
10100 Cedar Island Rd Bellevue NE 68123-5048 | |
| (402) 862-6762 | |
| Not Available |
| Full Name | Renewed Minds, Llc |
|---|---|
| Speciality | Counselor |
| Location | 10100 Cedar Island Rd, Bellevue, Nebraska |
| Authorized Official Name and Position | Laurie Jeanette Johnson (OWNER) |
| Authorized Official Contact | 4028626762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renewed Minds, Llc 6201 Kentucky Rd Papillion NE 68133-2372 Ph: (402) 862-6762 | Renewed Minds, Llc 10100 Cedar Island Rd Bellevue NE 68123-5048 Ph: (402) 862-6762 |
| NPI Number | 1184496523 |
|---|---|
| Provider Enumeration Date | 10/30/2023 |
| Last Update Date | 10/30/2023 |
| Certification Date | 10/28/2023 |
| Medicare PECOS PAC ID | 3072961937 |
|---|---|
| Medicare Enrollment ID | O20231204000290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184496523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Laurie Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043808793 PECOS PAC ID: 3971951831 Enrollment ID: I20231204000419 |
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