Organization
RENEWED LIFE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY RENEE GIBSON MS, ALC (OWNER/COUNSELOR)
(251) 376-4249
Entity
Organization
Contact information
Practice address
169 DAUPHIN ST STE 319, MOBILE, AL 36602-3271
(251) 376-4249
Mailing address
9029 DAWES OAK DR, THEODORE, AL 36582-9654
(251) 376-4249
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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