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NPI Code Detail

MEDICARE: J. DAVID RENOUF LCMHC

MEDICARE: J. DAVID RENOUF LCMHC
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
1101YM0800XMental Health Counselor167NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11406518Y0NH01OTHERNHBLUE CROSS
21039158OTHERNHCIGNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4020258994-74OTHERNHHARVARD PILGRIM

General Provider Information

NPI Number : 1841367166
Entity Type Code : Individual
Provider Name (Legal Business Name) : J. DAVID RENOUF LCMHC
Provider Business Mailing Address
First Line : 250 COMMERCIAL STREET
Second Line : SUITE 3004
City : MANCHESTER
State : NH
Zip : 03101-1118
Country : US
Telephone Number : 603-668-3050
Fax Number : 603-668-8666
Provider Business Practice Location Address
First Line : 250 COMMERCIAL STREET
Second Line : SUITE 3004
City : MANCHESTER
State : NH
Zip : 03101-1118
Country : US
Telephone Number : 603-668-3050
Fax Number : 603-668-8666
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 08/14/2014

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