Provider Demographics
NPI:1174970057
Name:REID, SHERYL MARIE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:MARIE
Last Name:REID
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:SHERYL
Other - Middle Name:MARIE
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:613 E BAJA DR
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-3417
Mailing Address - Country:US
Mailing Address - Phone:575-318-8153
Mailing Address - Fax:
Practice Address - Street 1:613 E BAJA DR
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-3417
Practice Address - Country:US
Practice Address - Phone:575-318-8153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-094701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical