Provider Demographics
NPI:1962440065
Name:RENNER, CAROLE J (LMHC)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:J
Last Name:RENNER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2194 HIGHWAY A1A
Mailing Address - Street 2:STE 203
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4930
Mailing Address - Country:US
Mailing Address - Phone:321-777-8930
Mailing Address - Fax:321-773-5479
Practice Address - Street 1:2194 HIGHWAY A1A
Practice Address - Street 2:STE 203
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4930
Practice Address - Country:US
Practice Address - Phone:321-777-8930
Practice Address - Fax:321-773-5479
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health