Kyle A. Reniche, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC 8308 Issued in ME

Practice address

12 Union St
Rockland, ME 04841-2739

Phone

(207) 701-4402

Fax

(207) 701-4486

NPI assigned

Aug 25, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1013164888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 ATLANTIC PLACE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062316",
            "telephone_number": "207-842-6556",
            "fax_number": "207-842-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 UNION ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412739",
            "telephone_number": "207-701-4402",
            "fax_number": "207-701-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENICHE",
        "first_name": "KYLE",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-25",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC 8308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Lynn Rainey, CCPC
• Abigale Razo, LCSW
• Michael W Reeves, LCSW
• Regional School Unit 13
• Amy C. Reid, M.A.
• Lauren Rice, IPDH
• Michael A Rich, P.T.
• Wendy B Rich, PT
• Emma Rose Richards, PTA
• Heather Ricker Morris, LCSW

• Clinical Social Worker in Rockland, ME
• Providers in Rockland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.