MEDICARE: RENEE M BENARD LLP

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	103T00000X	Psychologist	6361000220	MI

General Provider Information

NPI Number	:	1922347111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE M BENARD LLP

Provider Business Mailing Address
First Line	:	16402 PICARDIE WAY
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-9237
Country	:	US
Telephone Number	:	517-258-2220
Fax Number	:	517-295-0370

Provider Business Practice Location Address
First Line	:	2127 UNIVERSITY PARK DR STE 300
Second Line	:
City	:	OKEMOS
State	:	MI
Zip	:	48864-5928
Country	:	US
Telephone Number	:	248-453-7525
Fax Number	:

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

Provider Enumeration Date	:	02/07/2013
Last Update Date	:	11/08/2025

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