Provider Demographics
NPI:1407940406
Name:RENSINK, JANET M (MSW)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:M
Last Name:RENSINK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 COURT ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-4604
Mailing Address - Country:US
Mailing Address - Phone:207-782-1051
Mailing Address - Fax:207-777-6321
Practice Address - Street 1:384 COURT ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-4604
Practice Address - Country:US
Practice Address - Phone:207-782-1051
Practice Address - Fax:207-777-6321
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELCLL291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MERE-MM9853Medicare ID - Type Unspecified