Provider Demographics
NPI:1346988144
Name:REID, BRENDALEE S (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:BRENDALEE
Middle Name:S
Last Name:REID
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 VICTORY CT
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12885-1249
Mailing Address - Country:US
Mailing Address - Phone:518-596-9660
Mailing Address - Fax:
Practice Address - Street 1:84 BROAD ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4386
Practice Address - Country:US
Practice Address - Phone:518-636-5284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032106-01101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional