Provider Demographics
NPI:1871951285
Name:HAINES, RENEE TAYLOR (MSW, LISW-S)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:TAYLOR
Last Name:HAINES
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:TAYLOR
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LISW-S
Mailing Address - Street 1:5783 KATARA DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8113
Mailing Address - Country:US
Mailing Address - Phone:614-204-9446
Mailing Address - Fax:
Practice Address - Street 1:2865 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-2643
Practice Address - Country:US
Practice Address - Phone:614-230-3481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI. 1200996 . SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical