Provider Demographics
NPI:1023243011
Name:REID, NATASHIA WYAKITA (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:NATASHIA
Middle Name:WYAKITA
Last Name:REID
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 MERCHANT CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-5302
Mailing Address - Country:US
Mailing Address - Phone:240-463-7437
Mailing Address - Fax:301-705-8892
Practice Address - Street 1:2940 MERCHANT CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-5302
Practice Address - Country:US
Practice Address - Phone:240-463-7437
Practice Address - Fax:301-705-8892
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical