Provider Demographics
NPI:1154957272
Name:RENEWED PATH COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:RENEWED PATH COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:318-512-5383
Mailing Address - Street 1:PO BOX 482
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71284-0482
Mailing Address - Country:US
Mailing Address - Phone:318-512-5383
Mailing Address - Fax:318-574-0819
Practice Address - Street 1:711 JOHNSON ST REAR OFFICE
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-4532
Practice Address - Country:US
Practice Address - Phone:318-512-5383
Practice Address - Fax:318-574-0819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty