Provider Demographics
NPI:1417561598
Name:REID, BLAIR (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:BLAIR
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 TOPANGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1737
Mailing Address - Country:US
Mailing Address - Phone:818-379-3340
Mailing Address - Fax:
Practice Address - Street 1:5353 TOPANGA CANYON BLVD STE 209
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1738
Practice Address - Country:US
Practice Address - Phone:818-379-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health