Organization
RENASCENCE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY GRAY (OFFICE MANAGER)
(703) 521-6004
Entity
Organization
Contact information
Practice address
46 S GLEBE RD STE 103, ARLINGTON, VA 22204-1671
(703) 521-6004
(703) 521-6342
Mailing address
46 S GLEBE RD STE 103, ARLINGTON, VA 22204-1671
(703) 521-6004
(703) 521-6342
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
04/15/2011
Last updated
04/15/2011
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