Provider Demographics
NPI:1942288253
Name:ANDERSON, RENEE I (PHD, LPCC, LPC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:I
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHD, LPCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 GRANDVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-3261
Mailing Address - Country:US
Mailing Address - Phone:724-290-4765
Mailing Address - Fax:
Practice Address - Street 1:111 GRANDVIEW BLVD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-3261
Practice Address - Country:US
Practice Address - Phone:724-290-4765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0008433101YP2500X
PAPC003762101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional