Provider Demographics
NPI:1700941952
Name:WEISS, RENEE LEE (LCSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:LEE
Last Name:WEISS
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CHATHAM RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2322
Mailing Address - Country:US
Mailing Address - Phone:973-376-1191
Mailing Address - Fax:973-376-5353
Practice Address - Street 1:58 CHATHAM RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2322
Practice Address - Country:US
Practice Address - Phone:973-376-1191
Practice Address - Fax:973-376-5353
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC002561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical