Provider Demographics
NPI:1821640376
Name:REID, COREY BETH (CAC-ADT)
Entity Type:Individual
Prefix:MS
First Name:COREY
Middle Name:BETH
Last Name:REID
Suffix:
Gender:F
Credentials:CAC-ADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 HEALTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-4470
Mailing Address - Country:US
Mailing Address - Phone:410-334-6961
Mailing Address - Fax:
Practice Address - Street 1:1113 HEALTHWAY DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-4470
Practice Address - Country:US
Practice Address - Phone:410-334-6169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)