Provider Demographics
NPI:1659782928
Name:REID, STEPHANIE H (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:H
Last Name:REID
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:NIELSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2655 14TH AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-8322
Mailing Address - Country:US
Mailing Address - Phone:719-216-7004
Mailing Address - Fax:
Practice Address - Street 1:2655 14TH AVENUE CT
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-8322
Practice Address - Country:US
Practice Address - Phone:970-408-0477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15137101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health