Provider Demographics
NPI:1538646138
Name:TERRY-REID, DENEASE RENEE (LPC)
Entity Type:Individual
Prefix:
First Name:DENEASE
Middle Name:RENEE
Last Name:TERRY-REID
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 CRAGHEAD ST STE 101A
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1468
Mailing Address - Country:US
Mailing Address - Phone:434-857-6290
Mailing Address - Fax:434-857-6290
Practice Address - Street 1:308 CRAGHEAD ST STE 101A
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1468
Practice Address - Country:US
Practice Address - Phone:434-857-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty