Provider Demographics
NPI:1760511158
Name:LION, RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:LION
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 DOMINICAN WAY
Mailing Address - Street 2:STE 110B
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1527
Mailing Address - Country:US
Mailing Address - Phone:831-469-5349
Mailing Address - Fax:831-479-0566
Practice Address - Street 1:1663 DOMINICAN WAY
Practice Address - Street 2:STE 110B
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1527
Practice Address - Country:US
Practice Address - Phone:831-469-5349
Practice Address - Fax:831-479-0566
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS187831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical