Provider Demographics
NPI:1346426665
Name:PEERLESS, RENEE CHANELLE (MSW, PLCSW)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:CHANELLE
Last Name:PEERLESS
Suffix:
Gender:F
Credentials:MSW, PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 VERNON ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-4606
Mailing Address - Country:US
Mailing Address - Phone:573-586-9244
Mailing Address - Fax:
Practice Address - Street 1:140 VERNON ST
Practice Address - Street 2:
Practice Address - City:SAINT ROBERT
Practice Address - State:MO
Practice Address - Zip Code:65584-4606
Practice Address - Country:US
Practice Address - Phone:573-586-9244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080001871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical