Provider Demographics
NPI:1962198242
Name:RENTAS, BRENMARIE (LSW)
Entity type:Individual
Prefix:MRS
First Name:BRENMARIE
Middle Name:
Last Name:RENTAS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 NEW MILLS DR
Mailing Address - Street 2:
Mailing Address - City:PEMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08068-1550
Mailing Address - Country:US
Mailing Address - Phone:609-722-7653
Mailing Address - Fax:
Practice Address - Street 1:1540 KUSER RD STE A3
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3828
Practice Address - Country:US
Practice Address - Phone:609-475-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06484600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker