Individual provider Active NPI

Brian Renard, MSW, L.I.C.S.W.

  • Clinical Social Worker
  • Hyannis, MA
National Provider Identifier
1447317458
Registry record updated Feb 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
60 Perseverance Way
Hyannis, MA 02601-1843
Phone
(508) 224-8041
NPI assigned
Jan 2, 2007
Last updated
Feb 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2010

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 Primary

Addresses

Primary practice location

60 Perseverance Way
Hyannis, MA 02601-1843

Mailing address

PO Box 79
Truro, MA 02666-0079
Phone (508) 487-6239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111222000244 MA Practitioner - Clinical Social Worker 0143496182 Practice locations: Orleans, MA; Provincetown, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

85 RT
6A Unit Aoffice1
Orleans, MA 02653-2465
Phone (508) 737-9276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1447317458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79",
            "city": "TRURO",
            "state": "MA",
            "postal_code": "026660079",
            "telephone_number": "508-487-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PERSEVERANCE WAY",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026011843",
            "telephone_number": "508-224-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENARD",
        "first_name": "BRIAN",
        "credential": "MSW,  L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.