Renaowen Counseling LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

RENAOWEN COUNSELING LLC

Doing business as

Katelyn M Maddock

Practice address

48130 Royal Pointe Dr
Canton, MI 48187-5466

Phone

(734) 664-3345

Fax

(517) 323-9531

NPI assigned

Aug 26, 2020

Last updated

Feb 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cathy Gallegos

Title

Credentialing Manager

Phone

(517) 483-2461

Specialties & licenses 1

Addresses

Other names 1

• Katelyn M Maddock Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katelyn M Maddock, LLMSW

  • Clinical Social Worker
  • Canton, MI
  • NPI 1285292540
  NPD (past)

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1174136550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48130 ROYAL POINTE DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875466",
            "telephone_number": "734-207-5065",
            "fax_number": "517-323-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48130 ROYAL POINTE DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875466",
            "telephone_number": "734-664-3345",
            "fax_number": "517-323-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAOWEN COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "517-483-2461"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Katelyn M Maddock",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Katelyn M Maddock",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Social Worker in Canton, MI
• Providers in Canton, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.