Provider Demographics
NPI:1467830315
Name:REID, COLIN H (LCPC-C)
Entity Type:Individual
Prefix:MR
First Name:COLIN
Middle Name:H
Last Name:REID
Suffix:
Gender:M
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 HIGH ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3820
Mailing Address - Country:US
Mailing Address - Phone:207-518-8356
Mailing Address - Fax:
Practice Address - Street 1:95 HIGH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3820
Practice Address - Country:US
Practice Address - Phone:207-518-8356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4425101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional