Active NPI
Michelle Renaud
- Social Worker
- Farmington, NM
National Provider Identifier
1619296472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- C-09327
- Practice address
- 807 W Apache St
Farmington, NM 87401-5527 - Phone
- (505) 325-5358
- Fax
- (505) 326-3085
- NPI assigned
- May 19, 2010
- Last updated
- May 13, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Social Worker | 104100000X | C-09327 | NM | Primary |
Addresses
Primary practice location
807 W Apache St
Farmington, NM 87401-5527
Mailing address
807 W Apache St
Farmington, NM 87401-5527
Phone (505) 325-5358
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154389 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-09327 | NM | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childhaven, Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Foster Care Agency
- Farmington, NM
- NPI 1144303074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463097600000",
"number": "1619296472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 W APACHE ST",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015527",
"telephone_number": "505-325-5358",
"fax_number": "505-326-3085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 W APACHE ST",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015527",
"telephone_number": "505-325-5358",
"fax_number": "505-326-3085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENAUD",
"first_name": "MICHELLE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-19",
"last_updated": "2016-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "C-09327",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1154389",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.