Provider Demographics
NPI:1124404850
Name:RENNA, JOEL (LCSW)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:RENNA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:JOEL
Other - Middle Name:
Other - Last Name:RENNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4320 DIPLOMACY DR STE 1800
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5925
Mailing Address - Country:US
Mailing Address - Phone:907-854-8480
Mailing Address - Fax:
Practice Address - Street 1:4320 DIPLOMACY DR STE 1800
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5925
Practice Address - Country:US
Practice Address - Phone:907-854-8480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker