Provider Demographics
NPI:1952774499
Name:HUNT, RENNIE (LCASA)
Entity Type:Individual
Prefix:
First Name:RENNIE
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 S ASPEN ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-2735
Mailing Address - Country:US
Mailing Address - Phone:704-735-7325
Mailing Address - Fax:704-735-7370
Practice Address - Street 1:510 S ASPEN ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-2735
Practice Address - Country:US
Practice Address - Phone:704-735-7325
Practice Address - Fax:704-735-7370
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21782A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNAOtherREQUESTING NPI