Provider Demographics
NPI:1417747536
Name:REID, DENISE ANNMARIE (MENTAL HEALTH)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:ANNMARIE
Last Name:REID
Suffix:
Gender:F
Credentials:MENTAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-2118
Mailing Address - Country:US
Mailing Address - Phone:757-831-2466
Mailing Address - Fax:
Practice Address - Street 1:220 ELM AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2118
Practice Address - Country:US
Practice Address - Phone:757-831-2466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ138118163515101YA0400X
ZZ169218163515101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty