MEDICARE: LACEY J. RENTSCHLER-MILLER MSW, 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	34006187A	IN

General Provider Information

NPI Number	:	1508253543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACEY J. RENTSCHLER-MILLER MSW, LCSW

Provider Business Mailing Address
First Line	:	1700 W SMITH VALLEY RD STE B4
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46142-1589
Country	:	US
Telephone Number	:	317-886-1000
Fax Number	:	317-886-1001

Provider Business Practice Location Address
First Line	:	1700 W SMITH VALLEY RD STE B4
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46142-1589
Country	:	US
Telephone Number	:	317-886-1000
Fax Number	:	317-886-1001

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

Provider Enumeration Date	:	04/16/2015
Last Update Date	:	05/03/2016

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