| Doctor Name: | JESSICA A RENNER |
| NPI Number: | 1780994871 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., LCPC, SOTP |
| License Number: | 272000158 |
| Business Practice Address: | 1115 W Chestnut St Brockton, MA - 023017501 |
| Business Phone Number: | 5085804691 |
| Business Fax Number: | |
| Mailing Address: | 9239 Gross Point Rd, #300 SKOKIE |
| State: | IL |
| Postal Code: | 600771389 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/07/2010 |
| NPI Last Update Date: | 08/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 272000158 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |