Provider Demographics
NPI:1346974987
Name:REID, CHRISTA (LCSWA)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 CHICORA CLUB DR
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-5676
Mailing Address - Country:US
Mailing Address - Phone:910-818-0142
Mailing Address - Fax:
Practice Address - Street 1:104 TILGHMAN DR
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-5533
Practice Address - Country:US
Practice Address - Phone:910-892-1333
Practice Address - Fax:910-859-2929
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-11
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0176231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical