Kimberly Ann Renna

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

28 Sycamore Dr
Hazlet, NJ 07730-1833

Phone

(908) 902-6593

NPI assigned

Feb 22, 2019

Last updated

Feb 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1811454127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 SYCAMORE DR",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 SYCAMORE DR",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301833",
            "telephone_number": "908-902-6593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Sycamore Dr",
            "address_purpose": "LOCATION",
            "city": "Hazlet",
            "state": "NJ",
            "postal_code": "077301833",
            "country_code": "US",
            "telephone_number": "908-902-6593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENNA",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2949511045",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "Q1S1255211850010",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vinutha Raj, MD
• Essence Renee Reed-Williams, DSW, LSW
• Iwona Regula, APN
• Ashley Lynn Reha
• Melissa Anne Reilly, BCBA
• Constance Taylor Ricciardi, LSW
• Samantha Ricciardi
• Richard F Caponetti MD PA
• Lauren Grace Richards, APN, PMHNP-BC
• Josephine Myunghi Rim, M.D.

• Mental Health Counselor in Hazlet, NJ
• Providers in Hazlet, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.