Provider Demographics
NPI:1457380396
Name:RENAUD FINNEGAN, SHEILA D (LICSW)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:D
Last Name:RENAUD FINNEGAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 ELM ST SUITE 407
Mailing Address - Street 2:GREEN HOUSE GROUP
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101
Mailing Address - Country:US
Mailing Address - Phone:603-668-3050
Mailing Address - Fax:603-668-8666
Practice Address - Street 1:1361 ELM ST SUITE 407
Practice Address - Street 2:GREEN HOUSE GROUP
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101
Practice Address - Country:US
Practice Address - Phone:603-668-3050
Practice Address - Fax:603-668-8666
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH46104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
1401231Y0NH02OtherANTHEM PRIVATE PRACTICE
1401231Y0NH01OtherANTHEM GREEN HOUSE GROUP
NH30007773Medicaid
1033352OtherCIGNA
21522YMedicare UPIN
NHRE1956Medicare ID - Type Unspecified