Provider Demographics
NPI:1275622102
Name:REIDER, MONICA ROSS (EDD,LPCC-S,NCC,CRC)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:ROSS
Last Name:REIDER
Suffix:
Gender:F
Credentials:EDD,LPCC-S,NCC,CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 S COURT ST STE 5
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-2259
Mailing Address - Country:US
Mailing Address - Phone:330-723-7977
Mailing Address - Fax:
Practice Address - Street 1:230 S COURT ST STE 5
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2259
Practice Address - Country:US
Practice Address - Phone:330-723-7977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0500564101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL00015066OtherCERTIFIED REHABILITATION COUNSELOR
OH0500564-SUPVOtherLICENSED PROFESSIONAL CLINICAL COUNSELOR -SUPERVISING COUNSELOR
NC258350OtherNATIONAL CERTIFIED COUNSELOR