MR. MARK J. RENNER (NPI# 1609950211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609950211 |
| Entity Type | Individual |
| Full Name | MR. MARK J. RENNER |
| Credential | MS. LMHP, CPC, LIMHP |
| Practice Address |
748 N Main St Fremont NE 68025-5004 |
| Practice Telephone | 4029417016 |
| Practice Fax Number | 4029417018 |
| Mailing Telephone | 4029417016 |
| Mailing Fax Number | 4029417018 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2011-04-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 1320 | NE | Behavioral Health & Social Service Providers |
| N | 101Y00000X | Counselor | 2401 | NE | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
677 | NE | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
677 | NE | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | MEDICAID SA | 10025816100 | 01 |
| NE | 10025122100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205262862 | Mark Robert Renner | Behavioral Analyst | 316 Sw Elmwood Ave, Mcminnville, OR 97128-5914 | 2013-09-16 |
| 1225079346 | Mark Renner | Psychiatry & Neurology | 400 E Sheridan Rd, Melbourne, FL 32901-3122 | 2006-06-09 |
| Street Address |
748 N MAIN ST |
| City | FREMONT |
| State | NE |
| Zip Code | 68025-5004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972047074 | Gordy J Whitcomb | Counselor | 748 N Main St, Fremont, NE 68025-5004 | 2016-12-07 |
| 1861949539 | Associated Counseling Group | Counselor | 748 N Main St, Fremont, NE 68025-5004 | 2016-09-09 |
| 1316109507 | Anita J Renner | Counselor | 748 N Main St, Fremont, NE 68025-5004 | 2008-06-28 |
| 1457438152 | Melissa S Sharp | Counselor | 748 N Main St, Fremont, NE 68025-5004 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710456934 | Methodist Fremont Health | Pharmacy | 450 E 23rd, Fremont, NE 68025 | 2018-11-16 |
| 1811484546 | Cynthia Jane Cusick | Social Worker | 748 North Main Street, Fremont, NE 68025 | 2018-04-18 |
| 1891298196 | Hergenrader Dental Rehab PC | Dentist | 3102 East Elk Lane, Fremont, NE 68025 | 2018-03-13 |
| 1982142857 | Paula Y. Walla | Speech-Language Pathologist | 130 E. 9th St., Fremont, NE 68025 | 2017-02-10 |
| 1619326709 | Debra Baker | Nurse Practitioner | 3140 Elk Ln Ste 600, Fremont, NE 68025 | 2016-06-09 |
| 1912368069 | Nicole Henkel | Occupational Therapist | 450 East 23rd, Fremont, NE 68025 | 2016-03-17 |
| 1265818017 | Orchid of Hope Counseling | Exclusive Provider Organization | 1919 North Broad Street, Fremont, NE 68025 | 2015-08-04 |
| 1265770366 | James N Orr | Pharmacist | 840 E 23 St, Fremont, NE 68025 | 2013-01-24 |
| 1902156086 | Penelope Anastasia Stoll | Speech-Language Pathologist | Nye Legacy, 3210 N. Clarkson St, Fremont, NE 68025 | 2012-09-14 |
| 1144582685 | Diane Marie Gehring | Case Management | 105 East 12th Street, Fremont, NE 68025 | 2012-06-11 |
| Find all providers in zip 68025 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871101279 | Compass Behavioral Health, LLC | Counselor | 915 Croghan St, Fremont, OH 43420-2337 | 2020-07-21 |
| 1447897293 | Brandon Tomlinson | Counselor | 101 Norbert Dr, Fremont, OH 43420-9296 | 2019-11-27 |
| 1881166973 | Erin Kathleen Wegener | Counselor | 1835 E Military Ave Ste 115, Fremont, NE 68025-5477 | 2018-12-29 |
| 1417442997 | Bingqing Cui | Counselor | 39210 State St Ste 109, Fremont, CA 94538-1456 | 2018-06-26 |
| 1235629940 | Sharon Campbell | Counselor | 3100 Mowry Ave Ste 303, Fremont, CA 94538-1531 | 2018-05-17 |
| 1013447473 | Alicia Michelle Falcone | Counselor | 424 W 23rd St Ste D, Fremont, NE 68025-1211 | 2017-06-18 |
| 1194259853 | Fang Xie | Counselor | 39155 Liberty St. Suite E500, Fremont, CA 94538 | 2017-04-19 |
| 1184078974 | Jacqueline Rezac | Counselor | 424 W 23rd St Ste E, Fremont, NE 68025-1211 | 2016-04-18 |
| 1669848081 | Orchid of Hope Counseling | Counselor | 1835 E Military Ave Ste 129, Fremont, NE 68025-5477 | 2015-08-19 |
| 1336539626 | Rob A. Owens | Counselor | 230 E 22nd St Ste 4, Fremont, NE 68025-2661 | 2015-01-26 |
| Find all providers in FREMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.