Provider Demographics
NPI:1942452594
Name:REED, MAURA SULLIVAN (LCPC-C)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:SULLIVAN
Last Name:REED
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 AGAMENTICUS AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE NEDDICK
Mailing Address - State:ME
Mailing Address - Zip Code:03902-7109
Mailing Address - Country:US
Mailing Address - Phone:207-363-8568
Mailing Address - Fax:207-363-8568
Practice Address - Street 1:67 AGAMENTICUS AVE
Practice Address - Street 2:
Practice Address - City:CAPE NEDDICK
Practice Address - State:ME
Practice Address - Zip Code:03902-7109
Practice Address - Country:US
Practice Address - Phone:207-363-8568
Practice Address - Fax:207-363-8568
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL3390101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health