Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mind Renew, LLC

Organization Mental Health Counselor · NPI 1033740196

Mind Renew, LLC is a Mental Health Counselor in Surprise, Arizona. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12211 W Bell Rd
Surprise, AZ 85378-9521
Phone: (404) 953-2501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1033740196
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shockie Dersno — Owner · (404) 953-2501
NPI enumeratedJanuary 28, 2020
Last updated in NPPESJuly 1, 2025
Certification dateJuly 1, 2025
Mailing address13807 W Country Gables Dr, Surprise, AZ 85379-8338

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