Provider Demographics
NPI:1497764724
Name:RENETZKY, LARRY F I (LPC LMFT ACSW)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:F
Last Name:RENETZKY
Suffix:I
Gender:M
Credentials:LPC LMFT ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 CERVIN DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121-1205
Mailing Address - Country:US
Mailing Address - Phone:806-352-1974
Mailing Address - Fax:806-358-4296
Practice Address - Street 1:6141 W AMARILLO BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1901
Practice Address - Country:US
Practice Address - Phone:806-352-1974
Practice Address - Fax:806-358-4296
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC9306101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor