Provider Demographics
NPI:1912125923
Name:REID, MARGOT H (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MARGOT
Middle Name:H
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 1:1470 S BANANA RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-2802
Mailing Address - Country:US
Mailing Address - Phone:321-745-2815
Mailing Address - Fax:321-751-0079
Practice Address - Street 1:3270 SUNTREE BLVD
Practice Address - Street 2:109
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7530
Practice Address - Country:US
Practice Address - Phone:321-751-0155
Practice Address - Fax:321-751-0079
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health