Provider Demographics
NPI:1902234347
Name:REID, ALBERTA
Entity Type:Individual
Prefix:
First Name:ALBERTA
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALBERTA
Other - Middle Name:WINONA
Other - Last Name:MCGAHEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:919 W 21ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1515
Mailing Address - Country:US
Mailing Address - Phone:757-622-6794
Mailing Address - Fax:
Practice Address - Street 1:919 W 21ST ST STE B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1515
Practice Address - Country:US
Practice Address - Phone:757-622-6794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040082031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical