Basic Information
Provider Information
NPI: 1679891865
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRELITZ
FirstName: RENEE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 420 N CENTER DR
Address2: BUILDING 11 SUITE 141
City: NORFOLK
State: VA
PostalCode: 235024007
CountryCode: US
TelephoneNumber: 7574660700
FaxNumber: 7574614826
Practice Location
Address1: 420 N CENTER DR
Address2: BUILDING 11 SUITE 141
City: NORFOLK
State: VA
PostalCode: 235024007
CountryCode: US
TelephoneNumber: 7574660700
FaxNumber: 7574614826
Other Information
ProviderEnumerationDate: 05/12/2010
LastUpdateDate: 03/28/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X0904007201VAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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