Provider Demographics
NPI:1184887556
Name:REIMAN, SANDRA A (LCAS)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:REIMAN
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:A
Other - Last Name:REIMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2232 PAGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7723
Mailing Address - Country:US
Mailing Address - Phone:919-598-5000
Mailing Address - Fax:919-598-5007
Practice Address - Street 1:2232 PAGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-7723
Practice Address - Country:US
Practice Address - Phone:919-598-5000
Practice Address - Fax:919-598-5007
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1298101YA0400X
NCC0062531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6008033Medicaid
NC6006831Medicaid