Provider Demographics
NPI:1821571746
Name:EXELBERT, RENEE (PHD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:EXELBERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 BURD ST STE 102
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3225
Mailing Address - Country:US
Mailing Address - Phone:845-353-1370
Mailing Address - Fax:
Practice Address - Street 1:444 COMMUNITY DR STE 207
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3820
Practice Address - Country:US
Practice Address - Phone:516-313-1929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-07
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016582-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist