MEDICARE: SALINA RENNINGER, LLC

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	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1255295333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALINA RENNINGER, LLC

Provider Business Mailing Address
First Line	:	475 CLEVELAND AVE N STE 200
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-5053
Country	:	US
Telephone Number	:	651-285-8378
Fax Number	:	651-377-4346

Provider Business Practice Location Address
First Line	:	475 CLEVELAND AVE N STE 200
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-5053
Country	:	US
Telephone Number	:	651-285-8378
Fax Number	:	651-377-4346

Authorized Official
Title or Position	:	OWNER, PHD, LP
Name	:	SALINA RENNINGER
Credential	:	LP, PHD
Telephone Number	:	651-285-8378

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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