Individual
MR. JEFFREY SCOTT RENWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LICSW
Contact information
Practice address
5877 267TH ST, WYOMING, MN 55092-9282
(612) 672-1518
(651) 464-4847
Mailing address
5877 267TH ST, WYOMING, MN 55092-9282
(612) 672-1518
(651) 464-4847
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12222
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02G98RE
BLUE CROSS BLUE SHIELD
MN
01
—
1016928
PREFERRED ONE
MN
01
—
116136
UCARE
MN
01
—
1749701
UNITED HEALTHCARE
MN
01
—
20601
SIOUX VALLEY HEALTH
MN
05
—
232216100
—
MN
01
—
62-23551
UBH
MN
01
—
HP37851
HEALTH PARTNERS
MN
Enumeration date
08/13/2006
Last updated
07/30/2008
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