Provider Demographics
NPI:1023982758
Name:RENNEKE PSYCH, PLLC
Entity type:Organization
Organization Name:RENNEKE PSYCH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:RENNEKE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:612-293-7082
Mailing Address - Street 1:1600 18TH AVE NE UNIT 18028
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-5501
Mailing Address - Country:US
Mailing Address - Phone:612-293-7082
Mailing Address - Fax:
Practice Address - Street 1:1600 18TH AVE NE UNIT 18028
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-5501
Practice Address - Country:US
Practice Address - Phone:612-293-7082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty