Provider Demographics
NPI:1821042938
Name:CAVIN, RENEE JENSEN (RN, LCSW, CADC II)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:JENSEN
Last Name:CAVIN
Suffix:
Gender:F
Credentials:RN, LCSW, CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-2028
Mailing Address - Country:US
Mailing Address - Phone:601-442-1707
Mailing Address - Fax:601-442-3207
Practice Address - Street 1:176 LOWER WOODVILLE RD
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-4406
Practice Address - Country:US
Practice Address - Phone:601-442-1707
Practice Address - Fax:601-442-3207
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS90-007C101YA0400X
MSC64631041C0700X
MSR562483163WA0400X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health