Provider Demographics
NPI:1154508257
Name:MCNEILLY, RENEE J (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:J
Last Name:MCNEILLY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 SNAKE HILL RD
Mailing Address - Street 2:
Mailing Address - City:N SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-2919
Mailing Address - Country:US
Mailing Address - Phone:401-497-4496
Mailing Address - Fax:
Practice Address - Street 1:315 SNAKE HILL RD
Practice Address - Street 2:
Practice Address - City:N SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-2919
Practice Address - Country:US
Practice Address - Phone:401-497-4496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW021111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical