Provider Demographics
NPI:1790286052
Name:YORK, RENEE BETH (LSW)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:BETH
Last Name:YORK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:RENEE
Other - Middle Name:BETH
Other - Last Name:YORK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:1941 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16510-2347
Mailing Address - Country:US
Mailing Address - Phone:814-460-9966
Mailing Address - Fax:
Practice Address - Street 1:809 W 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-3205
Practice Address - Country:US
Practice Address - Phone:814-460-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133779101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor