Active NPI
Jessica Renard
- Professional Counselor
- Dallas, GA
National Provider Identifier
1851190516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- APC009658
- Practice address
- 2713 Charles Hardy Pkwy Ste 223
Dallas, GA 30157-9470 - Phone
- (229) 800-9695
- NPI assigned
- Mar 13, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APC009658 | GA | Primary |
Addresses
Primary practice location
2713 Charles Hardy Pkwy Ste 223
Dallas, GA 30157-9470
Mailing address
PO Box 748465
Atlanta, GA 30374-8465
Phone (855) 284-7483
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
803 Sunken Rd
Fredericksburg, VA 22401-5401
PO Box
Atlanta, GA 30374
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APC009658 | GA | MD | Professional Counselor |
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": "1741824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741824000000",
"number": "1851190516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 748465",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303748465",
"telephone_number": "855-284-7483",
"fax_number": "617-807-0958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2713 CHARLES HARDY PKWY STE 223",
"city": "DALLAS",
"state": "GA",
"postal_code": "301579470",
"telephone_number": "229-800-9695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENARD",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-13",
"last_updated": "2025-03-13",
"certification_date": "2025-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "APC009658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.