RENAISSANCE THERAPY CLINIC PLLC NPI 1407180284

NPI Information

  • NPI: 1407180284
  • Provider Name: RENAISSANCE THERAPY CLINIC PLLC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 1O WEST SQUARE LAKE RD
    SUITE 221
    BLOOMFIELD HILLS, MI
    ZIP 48302
  • Phone: (248) 990-0140

Map and Directions

Get Directions

NPI Details

RENAISSANCE THERAPY CLINIC PLLC is a professional counselor in Bloomfield Hills, MI. RENAISSANCE THERAPY CLINIC PLLC NPI is 1407180284. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1O WEST SQUARE LAKE RD
SUITE 221
BLOOMFIELD HILLS, MI
ZIP 48302-466
Phone: (248) 990-0140

The provider's authorized official is Vladimir Robert Vandalov .
The authorized official title is Owner and has the following contact phone number (248) 990-0140.

The enumeration date for this NPI number is 9/25/2009 and was last updated on 7/27/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinical6301000821MICHIGANNo
21041C0700XSocial WorkerClinical6801069906MICHIGANNo
3101YP2500XCounselorProfessional6401005273MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.