Individual provider Active NPI

Kereen Rennis

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1215330428
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
19 Gold St
Springfield, MA 01107-1324
Phone
(413) 221-6285
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary
Psychologist 103T00000X

Addresses

Primary practice location

19 Gold St
Springfield, MA 01107-1324

Mailing address

19 Gold St
Springfield, MA 01107-1324
Phone (413) 221-6285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240304003473 MA Practitioner - Mental Health Counselor 4981049657 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Human Development, Inc. Addiction (Substance Use Disorder) CurrentSince Jan 23, 2024 Accepting new patients
Center for Human Development, Inc CurrentSince Jan 23, 2024 Accepting new patients

Locations

102 Main St
Ste 2
Greenfield, MA 01301
Phone (413) 262-0193

102 Main St
Greenfield, MA 01301
Phone (413) 325-8500

332 Birnie Ave
Springfield, MA 01107
Phone (413) 439-2189

367 Pine St
Springfield, MA 01105
Phone (413) 737-1426

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": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1215330428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 GOLD ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071324",
            "telephone_number": "413-221-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 GOLD ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071324",
            "telephone_number": "413-221-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNIS",
        "first_name": "KEREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.