Provider Demographics
NPI:1104365907
Name:SOMERS, RENEE (LLP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:SOMERS
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:SZEWCZUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TLLP
Mailing Address - Street 1:6549 TOWN CENTER DR
Mailing Address - Street 2:STE. A
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4824
Mailing Address - Country:US
Mailing Address - Phone:248-855-1540
Mailing Address - Fax:
Practice Address - Street 1:6549 TOWN CENTER DR
Practice Address - Street 2:STE. A
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346
Practice Address - Country:US
Practice Address - Phone:248-855-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362007229103TC0700X
MI6301017006103TC0700X
MI6361007837103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical