MEDICARE: WILDRED RACHEL KRENIS MA, LMHC

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	101YM0800X	Mental Health Counselor	8729	MA

General Provider Information

NPI Number	:	1780095042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILDRED RACHEL KRENIS MA, LMHC

Provider Business Mailing Address
First Line	:	PO BOX 675153
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48267-5153
Country	:	US
Telephone Number	:	781-551-0999
Fax Number	:

Provider Business Practice Location Address
First Line	:	372 WASHINGTON ST STE A
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-6202
Country	:	US
Telephone Number	:	781-551-0999
Fax Number	:

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

Provider Enumeration Date	:	05/08/2014
Last Update Date	:	03/05/2026

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