Provider Demographics
NPI:1760468789
Name:GEBHART, RENEE M (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:M
Last Name:GEBHART
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 WATSON RD
Mailing Address - Street 2:STE. G101
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1528
Mailing Address - Country:US
Mailing Address - Phone:314-367-5500
Mailing Address - Fax:314-843-9212
Practice Address - Street 1:9200 WATSON RD
Practice Address - Street 2:STE. G101
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1528
Practice Address - Country:US
Practice Address - Phone:314-367-5500
Practice Address - Fax:314-843-9212
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020298371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical