Provider Demographics
NPI:1427261643
Name:KAIN, RENEE MARIE (MACP, LMHC)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:MARIE
Last Name:KAIN
Suffix:
Gender:F
Credentials:MACP, LMHC
Other - Prefix:MS
Other - First Name:RENEE
Other - Middle Name:MARIE
Other - Last Name:OLIVEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MACP, LMHC
Mailing Address - Street 1:72 PERKINS ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-2931
Mailing Address - Country:US
Mailing Address - Phone:978-290-7985
Mailing Address - Fax:
Practice Address - Street 1:857 TURNPIKE ST
Practice Address - Street 2:SUITE 136
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6140
Practice Address - Country:US
Practice Address - Phone:978-686-2900
Practice Address - Fax:978-686-2929
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1109101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health