Active NPI
Michelle Ann Renaud
- Clinical Social Worker
- Okemos, MI
National Provider Identifier
1982845418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801061555
- Practice address
- 3493 Woods Edge
Suite 103
Okemos, MI 48864-5911 - Phone
- (517) 886-3707
- Fax
- (517) 349-1973
- NPI assigned
- Mar 12, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801061555 | MI | Primary |
Addresses
Primary practice location
3493 Woods Edge
Suite 103
Okemos, MI 48864-5911
Mailing address
PO Box 43
Mason, MI 48854-0043
Phone (517) 623-6260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800C313060 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801061555 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253577600000",
"number": "1982845418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 43",
"city": "MASON",
"state": "MI",
"postal_code": "488540043",
"telephone_number": "517-623-6260",
"fax_number": "517-623-6460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3493 WOODS EDGE",
"address_2": "SUITE 103",
"city": "OKEMOS",
"state": "MI",
"postal_code": "488645911",
"telephone_number": "517-886-3707",
"fax_number": "517-349-1973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENAUD",
"first_name": "MICHELLE",
"middle_name": "ANN",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-12",
"last_updated": "2009-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801061555",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
"identifier": "800C313060",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Okemos, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.