Provider Demographics
NPI:1083366157
Name:REID, PAYTON (LMHC)
Entity Type:Individual
Prefix:MS
First Name:PAYTON
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4176 STADIUM DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5325
Mailing Address - Country:US
Mailing Address - Phone:561-676-3508
Mailing Address - Fax:
Practice Address - Street 1:4176 STADIUM DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5325
Practice Address - Country:US
Practice Address - Phone:561-676-3508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MH17933101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health