Provider Demographics
NPI:1225343817
Name:REED, REBECCA GRACE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:GRACE
Last Name:REED
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:PO BOX 972
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-1972
Mailing Address - Country:US
Mailing Address - Phone:207-619-2502
Mailing Address - Fax:207-514-7588
Practice Address - Street 1:40 FOREST FALLS DR STE 3
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-7005
Practice Address - Country:US
Practice Address - Phone:207-619-2502
Practice Address - Fax:207-514-7588
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC135731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical