MEDICARE: RENAE G. SINGLETARY LCSW

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
1	1041C0700X	Clinical Social Worker	107485-3501	UT

General Provider Information

NPI Number	:	1184660649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENAE G. SINGLETARY LCSW

Provider Business Mailing Address
First Line	:	255 W MAIN ST
Second Line	:
City	:	MT PLEASANT
State	:	UT
Zip	:	84647-1331
Country	:	US
Telephone Number	:	435-462-2416
Fax Number	:	435-462-9350

Provider Business Practice Location Address
First Line	:	51 N CENTER ST
Second Line	:
City	:	DELTA
State	:	UT
Zip	:	84624-8430
Country	:	US
Telephone Number	:	435-864-3073
Fax Number	:	435-864-3610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	10/20/2015

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Directions to “ RENAE G. SINGLETARY LCSW” Practice Location

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