Renae Robertson, BS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

407 N Basin Rd
Fairfield, IL 62837-9639

Phone

(618) 842-2125

NPI assigned

Mar 15, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1306349329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX M",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624500913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N BASIN RD",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628379639",
            "telephone_number": "618-842-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "RENAE",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20150720346262",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronnie Ray, PHARMD
• Angel L Rector, APRN,BC
• Susanne Remynse
• Virginia Ruth Reynolds, M.S., CCC-SLP
• Stacey Renee Robbins, M.S. CCC-SLP
• S E Illinois Counseling CTRS
• S Thomas Sehy D P M L L C
• Cheryl Lynn Savage, DT
• Christina L. Schuck, FNP-C
• Kenneth J Schweiss, P.A.

• Mental Health Counselor in Fairfield, IL
• Providers in Fairfield, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.