Provider Demographics
NPI:1184660532
Name:REID, DEBRA L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:L
Last Name:REID
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 1:149 HUNTSVILLE ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632
Mailing Address - Country:US
Mailing Address - Phone:479-244-7784
Mailing Address - Fax:
Practice Address - Street 1:149 HUNTSVILLE ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632
Practice Address - Country:US
Practice Address - Phone:479-244-7787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2152-C1041C0700X, 104100000X
AR2452-C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical