Provider Demographics
NPI:1538928742
Name:REID, RENITA MARTINE' (LPC)
Entity type:Individual
Prefix:
First Name:RENITA
Middle Name:MARTINE'
Last Name:REID
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7239 ARRINGTON ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3685
Mailing Address - Country:US
Mailing Address - Phone:757-892-4925
Mailing Address - Fax:
Practice Address - Street 1:5131 RIVER CLUB DR STE 200
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3837
Practice Address - Country:US
Practice Address - Phone:804-375-1392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health