Provider Demographics
NPI:1134310626
Name:RENNER, KIMBERLY H (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:H
Last Name:RENNER
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 S MILWAUKEE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2509
Mailing Address - Country:US
Mailing Address - Phone:303-871-8718
Mailing Address - Fax:303-780-9192
Practice Address - Street 1:50 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5103
Practice Address - Country:US
Practice Address - Phone:303-780-9191
Practice Address - Fax:303-780-9192
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLCSW 9921921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical