Provider Demographics
NPI:1467618314
Name:KAYE RENSHAW, P.C., COUNSELING AND CONSULTATION
Entity Type:Organization
Organization Name:KAYE RENSHAW, P.C., COUNSELING AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:PROF
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, PHD
Authorized Official - Phone:806-354-9997
Mailing Address - Street 1:PO BOX 50660
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-0660
Mailing Address - Country:US
Mailing Address - Phone:806-354-9997
Mailing Address - Fax:806-354-9991
Practice Address - Street 1:7480 GOLDEN POND PL
Practice Address - Street 2:SUITE 400
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1962
Practice Address - Country:US
Practice Address - Phone:806-354-9997
Practice Address - Fax:806-354-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12378101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0264285-02Medicaid
TX82624LOtherBLUE CROSS BLUE SHIELD
TX0264285-01Medicaid
TX122353100OtherFIRST CARE SOUTHWEST LIFE AND HEALTH
TX216750000OtherMAGELLAN BEHAVIORAL HEALTH