Provider Demographics
NPI:1649670126
Name:DUCHARME-BRODIE, RENEE (LMHC)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:DUCHARME-BRODIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 1ST AVE STE 2B4
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3270
Mailing Address - Country:US
Mailing Address - Phone:360-931-0937
Mailing Address - Fax:360-852-9624
Practice Address - Street 1:1801 1ST AVE STE 2B4
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632
Practice Address - Country:US
Practice Address - Phone:360-931-0937
Practice Address - Fax:360-353-3232
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor