Provider Demographics
NPI:1316781347
Name:REIS, LINDSEY MARIE (LCMHCA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:REIS
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:REIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMHCA
Mailing Address - Street 1:4360 BOSTIC DR APT 204
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-9429
Mailing Address - Country:US
Mailing Address - Phone:210-551-8339
Mailing Address - Fax:
Practice Address - Street 1:2902 N HERRITAGE ST STE A
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1580
Practice Address - Country:US
Practice Address - Phone:252-686-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20132101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health