Provider Demographics
NPI:1124831318
Name:RENOVATING HOPE COUNSELING AND SPIRITUAL DIRECTION, LLC
Entity type:Organization
Organization Name:RENOVATING HOPE COUNSELING AND SPIRITUAL DIRECTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHOEMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MAED
Authorized Official - Phone:843-412-0776
Mailing Address - Street 1:555 SUN VALLEY DR STE L3
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5630
Mailing Address - Country:US
Mailing Address - Phone:404-369-8957
Mailing Address - Fax:
Practice Address - Street 1:555 SUN VALLEY DR STE L3
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5630
Practice Address - Country:US
Practice Address - Phone:404-369-8957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health