Provider Demographics
NPI:1386833234
Name:HANCOCK, RENEE JEAN (QMHP, CADC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:JEAN
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:QMHP, CADC
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:JEAN
Other - Last Name:HATCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:QMHP
Mailing Address - Street 1:3325 HAROLD DR NE
Mailing Address - Street 2:PO BOX 17818
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305
Mailing Address - Country:US
Mailing Address - Phone:503-363-2021
Mailing Address - Fax:
Practice Address - Street 1:3325 HAROLD DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1339
Practice Address - Country:US
Practice Address - Phone:503-363-2021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)