Provider Demographics
NPI:1144469172
Name:RENZ, CATHY CHONOLES (LICSW)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:CHONOLES
Last Name:RENZ
Suffix:
Gender:F
Credentials:LICSW
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 2
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-0002
Mailing Address - Country:US
Mailing Address - Phone:339-364-8510
Mailing Address - Fax:339-230-0813
Practice Address - Street 1:1032 TURNPIKE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2865
Practice Address - Country:US
Practice Address - Phone:339-364-8510
Practice Address - Fax:339-230-0813
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-15
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1144021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical