| Carol Renninger, LISW | |
|
1960 N Date St, T Or C, NM 87901-3701 | |
| (505) 267-3088 | |
| (505) 267-1747 |
| Full Name | Carol Renninger |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 1960 N Date St, T Or C, New Mexico |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023001013 | NPI | - | NPPES |
| 92320848 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | I05359 (New Mexico) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Carol Renninger, LISW 255 Hwy 187, Hatch, NM 87937-0370 Ph: (505) 267-3088 | Carol Renninger, LISW 1960 N Date St, T Or C, NM 87901-3701 Ph: (505) 267-3088 |
Jim Vigil, Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 N Date St, T Or C, NM 87901 Phone: 575-894-7459 | |
Joi Holsapple, Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 N Date St, T Or C, NM 87901 Phone: 575-894-7589 | |
Patrick Ercolino, Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 N Date St, T Or C, NM 87901 Phone: 575-894-7459 |