Provider Demographics
NPI:1265802003
Name:EID-REINER, ERIC (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:EID-REINER
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:ERIC
Other - Middle Name:
Other - Last Name:EID-REINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:123 HAVEN ST # 386
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-2952
Mailing Address - Country:US
Mailing Address - Phone:617-398-7066
Mailing Address - Fax:
Practice Address - Street 1:205 WILLOW ST STE B3A
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-2253
Practice Address - Country:US
Practice Address - Phone:617-398-7066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4849921041S0200X
MA1211221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool