Provider Demographics
NPI:1427347624
Name:RENO, MICHAEL PAUL (LMHC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PAUL
Last Name:RENO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2520
Mailing Address - Country:US
Mailing Address - Phone:508-753-5425
Mailing Address - Fax:508-753-9625
Practice Address - Street 1:20 CEDAR ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2520
Practice Address - Country:US
Practice Address - Phone:508-753-5425
Practice Address - Fax:508-753-9625
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6043101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health