Provider Demographics
NPI:1386833234
Name:HANCOCK, RENEE JEAN (PROF COUNSELOR ASSOC)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:JEAN
Last Name:HANCOCK
Suffix:
Gender:
Credentials:PROF COUNSELOR ASSOC
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:JEAN
Other - Last Name:HATCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5868 MONTEVALLO ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-9010
Mailing Address - Country:US
Mailing Address - Phone:503-580-9124
Mailing Address - Fax:
Practice Address - Street 1:5868 MONTEVALLO ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-9010
Practice Address - Country:US
Practice Address - Phone:503-580-9124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT-25-5072101YA0400X
ORR11024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)