Individual provider Active NPI

Renee M. Levesque, M.S.W., LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1306963798
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14676 Issued in FM
Practice address
130 Wabasha St S Ste 90
Saint Paul, MN 55107-1819
Phone
(651) 925-8453
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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 14676 FM Primary

Addresses

Primary practice location

130 Wabasha St S Ste 90
Saint Paul, MN 55107-1819

Mailing address

130 Wabasha St S Ste 90
Saint Paul, MN 55107-1819
Phone (651) 925-8453

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14676FMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Guild PastSince Sep 25, 2019 Accepting new patients
Guild PastSince Sep 25, 2019 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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1306963798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 WABASHA ST S STE 90",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071819",
            "telephone_number": "651-925-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WABASHA ST S STE 90",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071819",
            "telephone_number": "651-925-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVESQUE",
        "first_name": "RENEE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "M.S.W., LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FM",
            "license": "14676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.