Kevin D Renno, LMHC, MS | |
909 E State Blvd, Fort Wayne, IN 46805-3404 | |
(260) 481-2700 | |
(260) 481-2717 |
Full Name | Kevin D Renno |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 909 E State Blvd, Fort Wayne, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366469223 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 39000494A (Indiana) | Primary |
Entity Name | Northeastern Center, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720140908 PECOS PAC ID: 6709795636 Enrollment ID: O20040605000289 |
Mailing Address | Practice Location Address |
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Kevin D Renno, LMHC, MS 909 E State Blvd, Fort Wayne, IN 46805-3404 Ph: (260) 481-2700 | Kevin D Renno, LMHC, MS 909 E State Blvd, Fort Wayne, IN 46805-3404 Ph: (260) 481-2700 |
Courtney Lesley Washington, Counselor Medicare: Accepting Medicare Assignments Practice Location: 909 E State Blvd, Fort Wayne, IN 46805 Phone: 260-481-2700 | |
Alicia Jean Digiulio, MA, MSED, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9417 Saint Joe Center Rd, Fort Wayne, IN 46835 Phone: 260-255-5289 | |
Jennifer Perry, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 909 E State Blvd, Fort Wayne, IN 46805 Phone: 260-481-2700 Fax: 260-481-2709 | |
Raphilla D Dixie, Counselor Medicare: Medicare Enrolled Practice Location: 3005 E State Blvd, Fort Wayne, IN 46805 Phone: 260-267-9498 Fax: 260-739-3618 | |
Timothy Jay Hill, MSED Counselor Medicare: Not Enrolled in Medicare Practice Location: 2100 Goshen Rd, Fort Wayne, IN 46808 Phone: 260-471-3500 | |
Rita Kay Self, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3010 E State Blvd, Fort Wayne, IN 46805 Phone: 260-471-2300 Fax: 260-471-2778 | |
Rachida Bejja, MSED, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10828 Coldwater Rd, Fort Wayne, IN 46845 Phone: 260-415-8267 Fax: 260-426-0270 |