Healthcare Provider Details

I. General information

NPI: 1831722834
Provider Name (Legal Business Name): INGLE REID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1183 UNIVERSITY DR STE 105
BURLINGTON NC
27215-8315
US

IV. Provider business mailing address

411 WILLOW BROOK CT
MEBANE NC
27302-8358
US

V. Phone/Fax

Practice location:
  • Phone: 336-541-2390
  • Fax:
Mailing address:
  • Phone: 919-824-4386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15219
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: