Provider Demographics
NPI:1962732925
Name:CROUSE, RENAY LETTE (LISW)
Entity type:Individual
Prefix:MRS
First Name:RENAY
Middle Name:LETTE
Last Name:CROUSE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEW WILMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16142-1116
Mailing Address - Country:US
Mailing Address - Phone:724-946-8711
Mailing Address - Fax:724-946-9612
Practice Address - Street 1:241 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEW WILMINGTON
Practice Address - State:PA
Practice Address - Zip Code:16142-1116
Practice Address - Country:US
Practice Address - Phone:724-946-8711
Practice Address - Fax:724-946-9612
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI. 00092261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical