Provider Demographics
NPI:1922268499
Name:REID, PATTI J (LCPC)
Entity Type:Individual
Prefix:MS
First Name:PATTI
Middle Name:J
Last Name:REID
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAUCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:60084-1824
Mailing Address - Country:US
Mailing Address - Phone:847-687-1846
Mailing Address - Fax:
Practice Address - Street 1:3800 N WILKE RD
Practice Address - Street 2:STE 160
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1278
Practice Address - Country:US
Practice Address - Phone:847-687-1846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional