Basic Information
| Provider Information | |||||||||
| NPI: | 1508073487 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | VERONICA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | C.A.S.A.C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 76 HAYES ST | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115302409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165783288 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 71 HOMECREST CT | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115722209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167666283 | ||||||||
| FaxNumber: | 5167663705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 19613 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.