Provider Demographics
NPI:1912193186
Name:PIERCE, RENEE L (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:L
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 PROSPECT AVE
Mailing Address - Street 2:BUSINESS OFFICE
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203
Mailing Address - Country:US
Mailing Address - Phone:315-448-5375
Mailing Address - Fax:315-448-6506
Practice Address - Street 1:742 JAMES ST
Practice Address - Street 2:OUTPATIENT MENTAL HEALTH
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2017
Practice Address - Country:US
Practice Address - Phone:315-703-2700
Practice Address - Fax:315-703-2730
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73 0796731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical