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NPI Code Detail

MEDICARE: MR. CRAIG A RENS MA, LMFT

MEDICARE: MR. CRAIG A RENS MA, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist1624MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HP71690OTHERMNHEALTHPARTNERS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
318B75SOOTHERMNBCBS SOLUTIONS COUNSELING

General Provider Information

NPI Number : 1578683801
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CRAIG A RENS MA, LMFT
Provider Business Mailing Address
First Line : 703 THIELEN DR
Second Line :
City : SAINT MICHAEL
State : MN
Zip : 55376-9613
Country : US
Telephone Number : 763-515-4563
Fax Number :
Provider Business Practice Location Address
First Line : 703 THIELEN DR
Second Line :
City : SAINT MICHAEL
State : MN
Zip : 55376-9613
Country : US
Telephone Number : 763-515-4563
Fax Number : 763-497-0552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 03/08/2023

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