Provider Demographics
NPI:1013094259
Name:WEEKS, RENEE (LCMHC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:WEEKS
Suffix:
Gender:F
Credentials:LCMHC
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 5
Mailing Address - Street 2:
Mailing Address - City:WEST NEWBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05085-0005
Mailing Address - Country:US
Mailing Address - Phone:802-439-5153
Mailing Address - Fax:
Practice Address - Street 1:11 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:VT
Practice Address - Zip Code:05060-1330
Practice Address - Country:US
Practice Address - Phone:802-728-4466
Practice Address - Fax:802-728-4197
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000610101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009455OtherVHAP
VT2132009OtherCIGNA
VT14Y001579VY01OtherANTHEM
VT59254OtherBLUE CROSS