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Organization
RENEW COUNSELING CENTER OF NC LLC
Active
Organization
RENEW COUNSELING CENTER OF NC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NORMA IVELISS NEGRON MA (CEO)
(910) 476-6420
Entity
Organization
Contact information
Practice address
5114 YADKIN RD STE 100, FAYETTEVILLE, NC 28303-3251
(910) 779-0454
(910) 491-0833
Mailing address
5114 YADKIN RD STE 100, FAYETTEVILLE, NC 28303-3251
(910) 779-0454
(910) 491-0833
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
MHL-026-954
NC
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111783
—
NC
Enumeration date
05/28/2014
Last updated
09/16/2026
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