Provider Demographics
NPI:1346312915
Name:REID, JOHN H (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:H
Last Name:REID
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 S SHIELD
Mailing Address - Street 2:BLDG E SUITE 100
Mailing Address - City:FT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526
Mailing Address - Country:US
Mailing Address - Phone:970-495-4689
Mailing Address - Fax:970-484-9454
Practice Address - Street 1:2001 S SHIELD
Practice Address - Street 2:BLDG E SUITE 100
Practice Address - City:FT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526
Practice Address - Country:US
Practice Address - Phone:970-495-4689
Practice Address - Fax:970-484-9454
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO876249103T00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO027223OtherVALUE OPTIONS
CO027223OtherVALUE OPTIONS