Provider Demographics
NPI:1538354782
Name:REID, REBECCA S (MAED, LPC, NCC, NLP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:S
Last Name:REID
Suffix:
Gender:F
Credentials:MAED, LPC, NCC, NLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 TRYON RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-4107
Mailing Address - Country:US
Mailing Address - Phone:919-427-2956
Mailing Address - Fax:
Practice Address - Street 1:5040 TRYON RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-4107
Practice Address - Country:US
Practice Address - Phone:919-427-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC889101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional