Provider Demographics
NPI:1427262815
Name:NOTO, RENEL S (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:RENEL
Middle Name:S
Last Name:NOTO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4577 W PECOS RD
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-9002
Mailing Address - Country:US
Mailing Address - Phone:520-550-6008
Mailing Address - Fax:520-550-6033
Practice Address - Street 1:4577 W PECOS RD
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-9002
Practice Address - Country:US
Practice Address - Phone:520-550-6008
Practice Address - Fax:520-550-6033
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-135841041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ415712Medicaid