Provider Demographics
NPI:1023985496
Name:REID, MAURICE S
Entity type:Individual
Prefix:MR
First Name:MAURICE
Middle Name:S
Last Name:REID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7820 HOLLISWOOD CT APT 906
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-3185
Mailing Address - Country:US
Mailing Address - Phone:704-293-6922
Mailing Address - Fax:704-900-5522
Practice Address - Street 1:7820 HOLLISWOOD CT APT 906
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-3185
Practice Address - Country:US
Practice Address - Phone:704-293-6922
Practice Address - Fax:704-900-5522
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCM2025-13326-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health