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Provider Information for 1700360732


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RENEE KATHERINE LAROCK-GARY LMHC


Other Names:  
Former Name: 
RENEE KATHERINE SWINTON LMHC

Sex: Female

NPI: 1700360732
Last Updated: 2022-08-29
Certification Date: 2022-08-29

Details

NameValue
NPI1700360732
Enumeration Date2018-09-15
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 5 MOREHOUS DR
TICONDEROGA, NY 12883-1110
United States

Phone: 518-480-7208 | Fax:844-283-6959
 
Primary Practice Address 5 MOREHOUS DR
TICONDEROGA, NY 12883-1110
United States

Phone: 518-586-4276 | Fax:844-283-6959
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YP2500X - Counselor - ProfessionalNY008982
Yes 101YM0800X - Counselor - Mental HealthNY008982