Provider Demographics
NPI:1144039496
Name:RENAUD, MATTHEW H (LCMHC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:H
Last Name:RENAUD
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05828-0185
Mailing Address - Country:US
Mailing Address - Phone:802-684-2275
Mailing Address - Fax:802-684-3839
Practice Address - Street 1:PO BOX 185
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VT
Practice Address - Zip Code:05828-0185
Practice Address - Country:US
Practice Address - Phone:802-684-2275
Practice Address - Fax:802-684-3839
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0136280101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health