Provider Demographics
NPI:1689007486
Name:RENWICK, ADRIENNE SUTHERLAND (LCPC, LCADC)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:SUTHERLAND
Last Name:RENWICK
Suffix:
Gender:F
Credentials:LCPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3881 N WESTPOINT DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6875
Mailing Address - Country:US
Mailing Address - Phone:775-762-6795
Mailing Address - Fax:
Practice Address - Street 1:730 S CENTER ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-2304
Practice Address - Country:US
Practice Address - Phone:775-302-9973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2020-05-07
Deactivation Date:2020-02-10
Deactivation Code:
Reactivation Date:2020-04-29
Provider Licenses
StateLicense IDTaxonomies
NV00279-LC101Y00000X
NVCI0054101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor