Provider Demographics
NPI:1538205984
Name:PRINCE, RENEE D (LMSW)
Entity type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:D
Last Name:PRINCE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 RED OAK RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3708
Mailing Address - Country:US
Mailing Address - Phone:347-891-5242
Mailing Address - Fax:
Practice Address - Street 1:1718 RED OAK RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-3708
Practice Address - Country:US
Practice Address - Phone:347-891-5242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0821291041C0700X
MD291611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical