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NPI Code Detail

MEDICARE: RENESCIA LANIQUE CHISOLM LCSW

MEDICARE: RENESCIA LANIQUE CHISOLM 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
11041C0700XClinical Social WorkerSW25355FL

General Provider Information

NPI Number : 1760264303
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENESCIA LANIQUE CHISOLM LCSW
Provider Business Mailing Address
First Line : 200 E ROBINSON ST STE 425
Second Line :
City : ORLANDO
State : FL
Zip : 32801-4347
Country : US
Telephone Number : 833-769-3524
Fax Number : 407-583-4988
Provider Business Practice Location Address
First Line : 200 E ROBINSON ST STE 425
Second Line :
City : ORLANDO
State : FL
Zip : 32801-4347
Country : US
Telephone Number : 833-769-3524
Fax Number : 407-583-4988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2023
Last Update Date : 10/09/2025

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1841830189 — LAUREN NICOLE DUMKA LMFT
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1811500507 — MS. JACQUELINE MARSHALL LMHC
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1568274785 — JAMILAH MALIKAH TULLOCH PMHNP
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Directions to “ RENESCIA LANIQUE CHISOLM LCSW” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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