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

Renaissance Therapy Clinic PLLC

Organization Professional Counselor · NPI 1407180284

Renaissance Therapy Clinic PLLC is a Professional Counselor in Bloomfield Hills, Michigan. Licensed in Michigan. Registered with an NPI since 2009.

Licensed in
MI
In the registry since
2009
Specialties on file
3
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1O W Square Lake Rd Ste 221
Bloomfield Hills, MI 48302-0466
Phone: (248) 990-0140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 6401005273 (MI)
Clinical Psychologist Taxonomy 103TC0700X · Licence 6301000821 (MI)
Clinical Social Worker Taxonomy 1041C0700X · Licence 6801069906 (MI)

Record details

NPI number1407180284
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Vladimir Vandalov — Owner · (248) 990-0140
NPI enumeratedSeptember 25, 2009
Last updated in NPPESJuly 27, 2010
Mailing address1o West Square Lake Rd, Suite 101, Bloomfield Hills, MI 48302-0466

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