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 provides Professional Counselor services 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 Not confirmed with CMS for 16 years — call before visiting
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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