Individual provider Active NPI

Brianna Renno

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1245607688
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095572 Issued in MI
Practice address
218 Fast Ice Dr
Midland, MI 48642-6167
Phone
(989) 631-2320
NPI assigned
Sep 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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 6801095572 MI Primary

Addresses

Primary practice location

218 Fast Ice Dr
Midland, MI 48642-6167

Mailing address

218 Fast Ice Dr
Midland, MI 48642-6167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200729003576 MI Practitioner - Clinical Social Worker 5395160998 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095572MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Bay Health Centers CurrentSince Mar 11, 2024 Accepting new patients
Great Lakes Bay Health Centers CurrentSince Mar 11, 2024 Accepting new patients
Saginaw County Community Mental Health Authority CurrentSince Dec 24, 2023 Accepting new patients

Locations

218 Fast Ice Dr
Midland, MI 48642
Phone (989) 631-2320

501 Lapeer Ave
#R
Saginaw, MI 48607
Phone (989) 753-6000

3023 Davenport Ave
Saginaw, MI 48602
Phone (989) 907-2761

500 Hancock St
Saginaw, MI 48602
Phone (989) 797-3400

Organizations & group practices 4

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": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1245607688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 FAST ICE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 FAST ICE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426167",
            "telephone_number": "989-631-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNO",
        "first_name": "BRIANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.