Individual provider Active NPI

Robert George Renna, M.ED, LMHC

  • Mental Health Counselor
  • Norwood, MA
National Provider Identifier
1477021087
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
544 Issued in MA
Practice address
89 Access Rd Ste 24
Norwood, MA 02062-5233
Phone
(781) 626-5463
Fax
(781) 626-5465
NPI assigned
Nov 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 544 MA Primary

Addresses

Primary practice location

89 Access Rd Ste 24
Norwood, MA 02062-5233

Mailing address

198 Stonehaven Drive
Weymouth, MA 02190
Phone (781) 835-6431

Other identifiers 1

IdentifierTypeStateIssuer
544OtherMALICENSED MENTAL HEALTH COUNSELOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • 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
I20240118000431 MA Practitioner - Mental Health Counselor 5991157661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
544MAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Child and Family Psychological Services, PLLC Mental Health PastSince Sep 17, 2007 Accepting new patients

Locations

872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone 6173804651 ext. 1992

101 Adams St
Ste 26
Quincy, MA 02169
Phone (469) 826-2779

Organizations & group practices 2

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": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1477021087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 STONEHAVEN DRIVE",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-835-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 ACCESS RD STE 24",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625233",
            "telephone_number": "781-626-5463",
            "fax_number": "781-626-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNA",
        "first_name": "ROBERT",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "M.ED, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MENTAL HEALTH COUNSELOR",
            "identifier": "544",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.