Glenn Henery Renaud, RECOVERY COACH

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

6821 Medbury St
Detroit, MI 48211-3317

Phone

(313) 909-2816

Fax

(586) 983-9797

NPI assigned

Jun 22, 2022

Last updated

Jun 22, 2022By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1427789262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6821 MEDBURY ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482113317",
            "telephone_number": "313-909-2816",
            "fax_number": "586-983-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6821 MEDBURY ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482113317",
            "telephone_number": "313-909-2816",
            "fax_number": "586-983-9797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37490 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483103503",
            "country_code": "US",
            "telephone_number": "586-480-1438",
            "fax_number": "586-983-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENAUD",
        "first_name": "GLENN",
        "middle_name": "HENERY",
        "credential": "RECOVERY COACH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renaissance Medical Center PLLC
• Renaissance Recovery
• Renal Treatment Centers Illinois Inc (West Detroit Dialysis)
• Renal Treatment Centers-Illinois Inc (New Center Dialysis)
• Elizabeth Renaud, CNP
• Patti Anne Renaud, RN
• Keisha Render, M.ED, CADC-DP
• Renew Physical Therapy Inc
• Renewal of Lifecare
• Joyce Renfroe

• Peer Specialist in Detroit, MI
• Providers in Detroit, MI by specialty
• Peer Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.