Provider Demographics
NPI:1144712415
Name:REAMS, KRISSY M (LCSW)
Entity type:Individual
Prefix:MISS
First Name:KRISSY
Middle Name:M
Last Name:REAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10152 HARVEST GOLD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-2891
Mailing Address - Country:US
Mailing Address - Phone:704-649-7190
Mailing Address - Fax:
Practice Address - Street 1:325 MCGILL AVE NW STE 521
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-6239
Practice Address - Country:US
Practice Address - Phone:980-277-2774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-03
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0142751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical