Active NPI
Renee Lynn Todd, LCSW
- Clinical Social Worker
- Longview, TX
National Provider Identifier
1467561209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 60852
- Practice address
- 107 Woodbine PL
Longview, TX 75601-2912 - Phone
- (800) 446-8253
- Fax
- (903) 234-1639
- NPI assigned
- Aug 29, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 60852 | TX | Primary |
| Clinical Social Worker | 1041C0700X | ASW12258 | CA |
Addresses
Primary practice location
107 Woodbine PL
Longview, TX 75601-2912
Mailing address
107 Woodbine PL
Longview, TX 75601-2912
Phone (800) 446-8253
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW12258 | CA | MD | Clinical Social Worker |
| 60852 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391
Organizations & group practices 1
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": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1467561209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 WOODBINE PL",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756012912",
"telephone_number": "800-446-8253",
"fax_number": "903-234-1639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 WOODBINE PL",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756012912",
"telephone_number": "800-446-8253",
"fax_number": "903-234-1639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TODD",
"first_name": "RENEE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "60852",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW12258",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.