Healthcare Provider Details

I. General information

NPI: 1770163354
Provider Name (Legal Business Name): KEVIN THOMAS REICH LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 NORTH POINT RD
BALTIMORE MD
21224-3338
US

IV. Provider business mailing address

1012 NORTH POINT RD
BALTIMORE MD
21224-3338
US

V. Phone/Fax

Practice location:
  • Phone: 443-216-4800
  • Fax:
Mailing address:
  • Phone: 443-216-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC11496
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: