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General NPI Number Information
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NPI Number | 1912193186
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Entity Type | Individual
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Provider Name | RENEE L PIERCE LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 742 JAMES ST OUTPATIENT MENTAL HEALTH
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City | SYRACUSE
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State | NY
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Zip | 13203-2017
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Country | US
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Telephone | 315-703-2700
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Fax | 315-703-2730
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Provider Business Mailing Address
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Address Line | 301 PROSPECT AVE BUSINESS OFFICE
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City | SYRACUSE
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State | NY
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Zip | 13203
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Country | US
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Telephone | 315-448-5375
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Fax | 315-448-6506
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 73 079673
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License Number State | NY
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