Provider Demographics
NPI:1023802964
Name:KIEL, RENEE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:MARIE
Last Name:KIEL
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 HORIZON DR W
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-6551
Mailing Address - Country:US
Mailing Address - Phone:630-333-5823
Mailing Address - Fax:
Practice Address - Street 1:527 ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-3335
Practice Address - Country:US
Practice Address - Phone:630-549-6245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0084311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical