Provider Demographics
NPI:1144642786
Name:DEVUYST, RENEE (LMHC)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:DEVUYST
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 1:407 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-1609
Mailing Address - Country:US
Mailing Address - Phone:315-331-2300
Mailing Address - Fax:315-331-2301
Practice Address - Street 1:407 E UNION ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1609
Practice Address - Country:US
Practice Address - Phone:315-331-2300
Practice Address - Fax:315-331-2301
Is Sole Proprietor?:No
Enumeration Date:2014-01-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000640101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health