Provider Demographics
NPI:1457544827
Name:REID, JOAN A (LMHC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:A
Last Name:REID
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CRISIS CENTER PLZ
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1238
Mailing Address - Country:US
Mailing Address - Phone:813-264-9955
Mailing Address - Fax:813-969-4950
Practice Address - Street 1:1 CRISIS CENTER PLZ
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-264-9955
Practice Address - Fax:813-969-4950
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9155101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1013902956OtherGROUP NPI