Provider Demographics
NPI:1992000996
Name:CARRICO, RENEE (EDS, MFT, ABSNP)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:CARRICO
Suffix:
Gender:F
Credentials:EDS, MFT, ABSNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:VERDI
Mailing Address - State:NV
Mailing Address - Zip Code:89439-0194
Mailing Address - Country:US
Mailing Address - Phone:775-842-0191
Mailing Address - Fax:
Practice Address - Street 1:495 APPLE ST
Practice Address - Street 2:SUITE 225
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3553
Practice Address - Country:US
Practice Address - Phone:775-842-0191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV39232101YS0200X, 103TS0200X
NV0712106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool