Provider Demographics
NPI:1861622193
Name:REICH, AMY SIDD (LPCC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SIDD
Last Name:REICH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 LUGAR DE MONTE VIS
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-8861
Mailing Address - Country:US
Mailing Address - Phone:505-690-9590
Mailing Address - Fax:
Practice Address - Street 1:4001 OFFICE COURT DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-4929
Practice Address - Country:US
Practice Address - Phone:505-983-8225
Practice Address - Fax:505-930-5427
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0225681101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health