Provider Demographics
NPI:1366076341
Name:RENEWED HOPE COUNSELING LLC
Entity type:Organization
Organization Name:RENEWED HOPE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:NGOTNGAMWONG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:918-268-6379
Mailing Address - Street 1:7935 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-8622
Mailing Address - Country:US
Mailing Address - Phone:918-268-6379
Mailing Address - Fax:918-992-2621
Practice Address - Street 1:7935 E 57TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-8622
Practice Address - Country:US
Practice Address - Phone:918-268-6379
Practice Address - Fax:918-992-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty