Provider Demographics
NPI:1457400939
Name:CM REID & ASSOCIATES INC
Entity type:Organization
Organization Name:CM REID & ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISANN
Authorized Official - Middle Name:
Authorized Official - Last Name:REID-CARRIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:352-365-6506
Mailing Address - Street 1:1510 PARK DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6738
Mailing Address - Country:US
Mailing Address - Phone:352-365-6506
Mailing Address - Fax:352-365-6596
Practice Address - Street 1:1514 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-4857
Practice Address - Country:US
Practice Address - Phone:352-365-6506
Practice Address - Fax:352-365-6596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW81451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID
Q0623Medicare UPIN