Provider Demographics
NPI:1124252390
Name:KLARIC, RENEE M (LPCC)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:M
Last Name:KLARIC
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 MAHONING AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-1808
Mailing Address - Country:US
Mailing Address - Phone:330-797-8800
Mailing Address - Fax:
Practice Address - Street 1:5204 MAHONING AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-1808
Practice Address - Country:US
Practice Address - Phone:330-797-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0007101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional