Provider Demographics
NPI:1568038727
Name:REIS, CAROLINE ANN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:ANN
Last Name:REIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MAXWELL DR # 1039
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-2920
Mailing Address - Country:US
Mailing Address - Phone:518-986-5713
Mailing Address - Fax:
Practice Address - Street 1:2 DEVON CT
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-7217
Practice Address - Country:US
Practice Address - Phone:518-986-5713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006281101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health