Nichole Marie Renadette, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

078153 Issued in NY

Practice address

22005 Jamaica Ave
Queens Village, NY 11428-2140

Phone

(718) 740-5000

Fax

(718) 479-0200

NPI assigned

Feb 3, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1407094170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 NATIONAL BLVD",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613311",
            "telephone_number": "516-680-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22005 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114282140",
            "telephone_number": "718-740-5000",
            "fax_number": "718-479-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENADETTE",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "078153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Refreshing Medical PC
• Rehabilitation Associates, Ny
• Andrea M Reid, LPN
• Stephen Remolina, M.D.,
• Antoine Rulbert Remy, RN
• Jennifer Reynolds, RN
• Ebony Rhem, RPH
• Starmecca Richardson
• Tito P Richardson
• Janelle Amanda Richmond, RN

• Social Worker in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.