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NPI Code Detail

MEDICARE: ASHLEY RENOCK LMSW

MEDICARE: ASHLEY RENOCK LMSW
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
1104100000XSocial Worker6801104509MI

General Provider Information

NPI Number : 1992312425
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY RENOCK LMSW
Provider Business Mailing Address
First Line : 23100 JEFFERSON AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48080-2756
Country : US
Telephone Number : 586-335-2006
Fax Number :
Provider Business Practice Location Address
First Line : 23100 JEFFERSON AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48080-2756
Country : US
Telephone Number : 586-335-2006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2020
Last Update Date : 06/11/2025

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Directions to “ ASHLEY RENOCK LMSW” Practice Location

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