Individual provider Active NPI

Renee L Genin, LCSW

  • Clinical Social Worker
  • Brookfield, WI
National Provider Identifier
1013185537
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7050-123 Issued in WI
Practice address
2515 N 124TH St
Suite 101
Brookfield, WI 53005-4675
Phone
(262) 641-4347
NPI assigned
Feb 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7050-123 WI Primary

Addresses

Primary practice location

2515 N 124TH St
Suite 101
Brookfield, WI 53005-4675

Mailing address

13105 W Bluemound Rd
Suite 100
Brookfield, WI 53005-8022
Phone (262) 641-9790

Other identifiers 2

IdentifierTypeStateIssuer
40954700MedicaidWI
11828858OtherWICAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7050-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Allergic Diseases SC Past Accepting new patients
Pathways Counseling Center II LLC PastSince Mar 8, 1998 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1013185537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13105 W BLUEMOUND RD",
            "address_2": "SUITE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058022",
            "telephone_number": "262-641-9790",
            "fax_number": "262-641-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 N 124TH ST",
            "address_2": "SUITE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054675",
            "telephone_number": "262-641-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENIN",
        "first_name": "RENEE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7050-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40954700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11828858",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.