Active NPI
Renee Michelle Santos, LMHC, LPCC
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1811143753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 7901
- Practice address
- 4660 Viewridge Ave
San Diego, CA 92123-1638 - Phone
- (619) 277-9188
- NPI assigned
- Aug 12, 2008
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10467 | MA | |
| Mental Health Counselor | 101YM0800X | 7901 | CA | Primary |
Addresses
Primary practice location
4660 Viewridge Ave
San Diego, CA 92123-1638
Mailing address
2561 Raymell Dr
San Diego, CA 92123-3543
Phone (508) 745-9362
Other practice location 1
2561 Raymell Dr
San Diego, CA 92123-3543
Phone (508) 745-9362
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 |
|---|---|---|---|
| 10467 | MA | MD | Mental Health Counselor |
| 7901 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wayside Youth and Family Support Network | Mental Health | 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Framingham, MA
- NPI 1851484505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1811143753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2561 RAYMELL DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921233543",
"telephone_number": "508-745-9362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4660 VIEWRIDGE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231638",
"telephone_number": "619-277-9188"
}
],
"practiceLocations": [
{
"address_1": "2561 Raymell Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921233543",
"country_code": "US",
"telephone_number": "508-745-9362",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANTOS",
"first_name": "RENEE",
"middle_name": "MICHELLE",
"credential": "LMHC, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-12",
"last_updated": "2023-02-14",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "10467",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "7901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.