Healthcare Provider Details

I. General information

NPI: 1356468912
Provider Name (Legal Business Name): VALERIE A RENSHAW LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 RIDGE RD
MARSHFIELD ME
04654-5122
US

IV. Provider business mailing address

220 RIDGE RD
MARSHFIELD ME
04654-5122
US

V. Phone/Fax

Practice location:
  • Phone: 207-263-8884
  • Fax:
Mailing address:
  • Phone: 207-263-8884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCC2699
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: