Provider Demographics
NPI:1689474678
Name:KAUCNIK, RENEE (COUNSELOR INTERN)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:KAUCNIK
Suffix:
Gender:
Credentials:COUNSELOR INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:POINT ARENA
Mailing Address - State:CA
Mailing Address - Zip Code:95468-0344
Mailing Address - Country:US
Mailing Address - Phone:847-401-4023
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1100
Practice Address - Street 2:
Practice Address - City:GUALALA
Practice Address - State:CA
Practice Address - Zip Code:95445-1100
Practice Address - Country:US
Practice Address - Phone:707-884-4005
Practice Address - Fax:707-884-9728
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health