Active NPI
Theresa Citarella Renna
- Mental Health Counselor
- Lexington, MA
National Provider Identifier
1427691856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11112
- Practice address
- 789 Massachusetts Ave Ste 20
Lexington, MA 02420-3927 - Phone
- (781) 205-9661
- NPI assigned
- Oct 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11112 | MA | Primary |
Addresses
Primary practice location
789 Massachusetts Ave Ste 20
Lexington, MA 02420-3927
Mailing address
789 Massachusetts Ave Ste 20
Lexington, MA 02420-3927
Phone (781) 205-9661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 28, 2025 through Jan 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700956800000",
"number": "1427691856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "789 MASSACHUSETTS AVE STE 20",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024203927",
"telephone_number": "781-205-9661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "789 MASSACHUSETTS AVE STE 20",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024203927",
"telephone_number": "781-205-9661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNA",
"first_name": "THERESA",
"middle_name": "CITARELLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-17",
"last_updated": "2023-11-26",
"certification_date": "2023-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "11112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.