Individual provider Active NPI

Renescia Lanique Chisolm, LCSW

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1760264303
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW25355 Issued in FL
Practice address
200 E Robinson St Ste 425
Orlando, FL 32801-4347
Phone
(833) 769-3524
Fax
(407) 583-4988
NPI assigned
Oct 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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 SW25355 FL Primary

Addresses

Primary practice location

200 E Robinson St Ste 425
Orlando, FL 32801-4347

Mailing address

200 E Robinson St Ste 425
Orlando, FL 32801-4347
Phone (833) 769-3524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251218002559 FL Practitioner - Clinical Social Worker 3375038227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

200 E Robinson St
Suite 425
Orlando, FL 32801-4347
Phone (404) 787-9777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW25355FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

200 E Robinson St
Ste 425
Orlando, FL 32801
Phone (407) 787-9777

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": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1760264303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E ROBINSON ST STE 425",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328014347",
            "telephone_number": "833-769-3524",
            "fax_number": "407-583-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E ROBINSON ST STE 425",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328014347",
            "telephone_number": "833-769-3524",
            "fax_number": "407-583-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISOLM",
        "first_name": "RENESCIA",
        "middle_name": "LANIQUE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW25355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.