Active NPI
Judith Lynn Renwick, LCSW
- Clinical Social Worker
- Nome, AK
National Provider Identifier
1639400864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW 887
- Practice address
- 306 W 5TH Ave
Norton Sound Health Corporation
Nome, AK 99762-0966 - Phone
- (907) 443-4540
- NPI assigned
- Jan 28, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW 887 | AK | Primary |
Addresses
Primary practice location
306 W 5TH Ave
Norton Sound Health Corporation
Nome, AK 99762-0966
Mailing address
PO Box 966
306 W 5TH Ave
Nome, AK 99762-0966
Phone (907) 443-4540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCSW 887 | Other | AK | LCSW 887 |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW 887 | AK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264636800000",
"number": "1639400864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 966",
"address_2": "306 W 5TH AVE",
"city": "NOME",
"state": "AK",
"postal_code": "997620966",
"telephone_number": "907-443-4540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 W 5TH AVE",
"address_2": "NORTON SOUND HEALTH CORPORATION",
"city": "NOME",
"state": "AK",
"postal_code": "997620966",
"telephone_number": "907-443-4540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENWICK",
"first_name": "JUDITH",
"middle_name": "LYNN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-28",
"last_updated": "2010-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AK",
"license": "LCSW 887",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW 887",
"identifier": "LCSW 887",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nome, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.