Provider Demographics
NPI:1780001990
Name:RENZ COUNSELING, LLC
Entity Type:Organization
Organization Name:RENZ COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:C
Authorized Official - Last Name:RENZ
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:339-364-8510
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-0002
Mailing Address - Country:US
Mailing Address - Phone:339-364-8510
Mailing Address - Fax:339-230-0813
Practice Address - Street 1:378 PAGE ST
Practice Address - Street 2:SUITE 6
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1124
Practice Address - Country:US
Practice Address - Phone:339-364-8080
Practice Address - Fax:781-436-5829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1144021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0026341Medicare PIN