Provider Demographics
NPI:1851816318
Name:RENEE LANDRENEAU, PLLC
Entity Type:Organization
Organization Name:RENEE LANDRENEAU, PLLC
Other - Org Name:RENEE LANDRENEAU, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LANDRENEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:870-918-2032
Mailing Address - Street 1:721 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SMACKOVER
Mailing Address - State:AR
Mailing Address - Zip Code:71762-1822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:721 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SMACKOVER
Practice Address - State:AR
Practice Address - Zip Code:71762-1822
Practice Address - Country:US
Practice Address - Phone:870-918-2032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty