MEDICARE: RENEE TONG LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW15038	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811494347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE TONG LCSW

Provider Business Mailing Address
First Line	:	7858 PARSONS PINE DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-7528
Country	:	US
Telephone Number	:	561-699-7708
Fax Number	:

Provider Business Practice Location Address
First Line	:	7858 PARSONS PINE DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-7528
Country	:	US
Telephone Number	:	561-699-7708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2018
Last Update Date	:	07/08/2019

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