Provider Demographics
NPI:1790408797
Name:REYES, COY (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:COY
Middle Name:
Last Name:REYES
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21405 DEVONSHIRE ST STE 207
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2939
Mailing Address - Country:US
Mailing Address - Phone:747-218-3106
Mailing Address - Fax:
Practice Address - Street 1:21405 DEVONSHIRE ST STE 207
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2939
Practice Address - Country:US
Practice Address - Phone:747-218-3106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1019991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical