MIND RENEW,LLC
NPI 1033740196
Counselor - Mental Health in Surprise, AZ

Q: What is Mind Renew,llc's NPI number?

The NPI number for Mind Renew,llc is 1033740196. It was assigned to this organization in the NPPES registry on January 28, 2020.

Q: What is Mind Renew,llc's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Mind Renew,llc was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 28, 2020

12211 W BELL RD, SURPRISE, AZ 85378(404) 953-2501 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 1, 2025, Jan 28, 2020 (2 updates tracked since 2020).

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About Mind Renew,llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIND RENEW,LLC (NPI 1033740196) is a healthcare organization registered as a mental health in Surprise, Arizona and active in the NPI registry since January 2020. The organization lists Shockie Dersno, Owner, as its authorized official.

NPPES Registry Identity

NPI1033740196

Entity TypeOrganization

Primary Taxonomy101YM0800X

Legal Business NameMIND RENEW,LLC

Location Address12211 W BELL RDSurprise, AZ 85378-9521

Mailing Address13807 W Country Gables DrSurprise, AZ 85379-8338 · (404) 953-2501

Phone(404) 953-2501

Organization SubpartNo

Authorized OfficialShockie DersnoOwner · (404) 953-2501

Enumeration DateJanuary 28, 2020

Last NPPES UpdateJuly 1, 20252 updates tracked since enumeration

NPPES CertifiedJuly 1, 2025

✔ NPI 1033740196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

12211 W BELL RD, Surprise, AZ 85378

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mind Renew,llc's NPI number?

The NPI number for Mind Renew,llc is 1033740196. It was assigned to this organization in the NPPES registry on January 28, 2020.

Where is Mind Renew,llc located?

Mind Renew,llc is located at 12211 W Bell Rd, Surprise, AZ 85378. The listed phone number is (404) 953-2501.

What is Mind Renew,llc's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Mind Renew,llc was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.