Kristina Marie Renaud, B.S., R.S.S.T

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6803074970 Issued in MI

Practice address

26184 Outer Dr
Lincoln Park, MI 48146-2084

Phone

(313) 389-7598

Fax

(313) 389-7515

NPI assigned

Jun 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962604348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 WILSON AVE",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462036",
            "telephone_number": "313-389-7598",
            "fax_number": "313-389-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26184 OUTER DR",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462084",
            "telephone_number": "313-389-7598",
            "fax_number": "313-389-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENAUD",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "B.S., R.S.S.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6803074970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.