Steven Edwin Reenan, LPC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2012004610 Issued in MO

Practice address

986 Highway a
Iberia, MO 65486-8242

Phone

(573) 793-2162

Fax

(573) 793-2162

NPI assigned

May 21, 2006

Last updated

May 29, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinical Research Associates, PC

  dba Long Term Psychiatric Management

  • Psychiatry Physician
  • Saint Louis, MO
  • NPI 1063632826
  Medicare reassignment

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

{
    "created_epoch": "1148169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1922052091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 HIGHWAY A",
            "city": "IBERIA",
            "state": "MO",
            "postal_code": "654868242",
            "telephone_number": "573-793-2162",
            "fax_number": "573-793-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986 HIGHWAY A",
            "city": "IBERIA",
            "state": "MO",
            "postal_code": "654868242",
            "telephone_number": "573-793-2162",
            "fax_number": "573-793-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REENAN",
        "first_name": "STEVEN",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-21",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2012004610",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "CS 001374",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Herzog, MT-BC, NMT
• Iberia R-V School District
• Lake Regional Health System (Lake Regional Clinic - Iberia)
• Medley Pharmacy Inc. (Sinks Pharmacy)
• Kyle Nichols, PHARM.D
• Gary N Thomsen, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Iberia, MO
• Providers in Iberia, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.