Provider Demographics
NPI:1366107062
Name:REYES, CARRIE ANN (LMHC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:REYES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 MULINER AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-2068
Mailing Address - Country:US
Mailing Address - Phone:914-886-3304
Mailing Address - Fax:
Practice Address - Street 1:315 5TH AVE RM 906
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6588
Practice Address - Country:US
Practice Address - Phone:347-815-3142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health