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JENNY RENVILLE DHA, MA, LCMHCA, NCC
NPI 1124670500
Counselor - Professional in Waxhaw, NC

Active since July 15, 2019PECOS EnrolledAccepts Medicare Assignment
104 WAXHAW PROFESSIONAL PARK DR STE D, WAXHAW, NC 28173(704) 277-9009 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 27, 2026, Mar 27, 2025, May 19, 2022 and 2 more (5 updates tracked since 2019).

About Jenny Renville Dha, Ma, Lcmhca, Ncc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNY RENVILLE DHA, MA, LCMHCA, NCC (NPI 1124670500) is an individual professional provider in Waxhaw, North Carolina, licensed in North Carolina (A16484) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS and is a graduate of Liberty Univ College Of Osteopathic Medicine (2020).

NPPES Registry Identity

NPI1124670500
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJENNY RENVILLECredential: DHA, MA, LCMHCA, NCC
Location Address104 WAXHAW PROFESSIONAL PARK DR STE DWaxhaw, NC 28173-5020
Mailing Address104 Waxhaw Professional Park Dr Ste DWaxhaw, NC 28173-5020 · (704) 277-9009
Phone(704) 277-9009
Sole ProprietorYes
Medical School CMSLiberty Univ College Of Osteopathic MedicineGraduated 2020
Enumeration DateJuly 15, 2019
Last NPPES UpdateApril 27, 20265 updates tracked since enumeration
NPPES CertifiedApril 27, 2026
✔ NPI 1124670500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in NC · A16484✔ Licensed in SC · 11794
Also ListedCounselorTaxonomy 101Y00000X · License A16484 (NC)
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 16481 (NC), A16484 (NC)
104 WAXHAW PROFESSIONAL PARK DR STE D, Waxhaw, NC 28173
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare, Oscar Health Plan of North Carolina, Inc and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jenny Renville Dha, Ma, Lcmhca, Ncc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6709378375
PECOS Enrollment IDI20251120004284
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Jenny Renville reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lifepath Holistic Counseling And Consulting, PLLC.
Same address
Professional
104 WAXHAW PROFESSIONAL PARK DR STE D
Waxhaw, NC 28173
  • Reassigned Medicare billing, North Carolina enrollment
NPI 1083338032 (704) 899-1555
Presbyterian Samaritan Counseling Center
15 mi
Mental Health
5203 SHARON RD
Charlotte, NC 28210
  • Reassigned Medicare billing, North Carolina enrollment
  • 8 clinicians in this Medicare group
NPI 1871679464 (704) 554-9900
Brightside Medical Of New Jersey, P.C.
2,315 mi
Psychiatry
5214F DIAMOND HEIGHTS BLVD # 345
San Francisco, CA 94131
  • Reassigned Medicare billing, North Carolina enrollment
  • Medicare enrollment name: Brightside Medical Of New Jersey PC
  • 112 clinicians in this Medicare group
NPI 1811524754 (415) 360-3348

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIFEPATH HOLISTIC COUNSELING AND CONSULTING, PLLC.
Counselor (Professional)
104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW, NC 28173
Union County (704) 899-1555
STEPHANIE COLSON
Counselor (Mental Health)
104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW, NC 28173
Union County (170) 467-2465
ROOTED RELATIONSHIPS COUNSELING & RECOVERY, PLLC
Counselor (Mental Health)
104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW, NC 28173
Union County (704) 255-4708
MELISSA H RATLIFF MD
Family Medicine
104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW, NC 28173
Union County (704) 443-8530
RATLIFF INTEGRATIVE MEDICINE, PLLC
Clinic/Center (Primary Care)
104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW, NC 28173
Union County (704) 560-5508
ANNA NICOLE KANTSIOS LMFT
Marriage & Family Therapist
104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW, NC 28173
Union County (704) 243-0326
TRUE MENTAL WELLNESS COUNSELING & CONSULTING
Counselor (Mental Health)
104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW, NC 28173
Union County (980) 315-5834
OSPREY COUNSELING SOLUTIONS, PLLLC
Counselor (Professional)
104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW, NC 28173
Union County (980) 257-6705

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jenny Renville's NPI number?

The NPI number for Jenny Renville is 1124670500. It was assigned to this individual provider in the NPPES registry on July 15, 2019.

Where is Jenny Renville located?

Jenny Renville practices at 104 Waxhaw Professional Park Dr Ste D, Waxhaw, NC 28173. The listed phone number is (704) 277-9009.

What is Jenny Renville's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jenny Renville enrolled in Medicare?

Yes. Jenny Renville is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jenny Renville's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jenny Renville reassigns Medicare benefits to 3 organizations: Lifepath Holistic Counseling And Consulting, PLLC. (Waxhaw, NC), Presbyterian Samaritan Counseling Center (Charlotte, NC) and Brightside Medical Of New Jersey, P.C. (San Francisco, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jenny Renville's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jenny Renville accept?

Health plans from Blue Cross and Blue Shield of NC, Cigna Healthcare, Oscar Health Plan of North Carolina, Inc and UnitedHealthcare list Jenny Renville as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jenny Renville was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.