Healthcare Provider Details

I. General information

NPI: 1417866948
Provider Name (Legal Business Name): JAINA REID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 BROADWAY
NEWPORT RI
02840-1471
US

IV. Provider business mailing address

6 LAFLAMME AVE
WOONSOCKET RI
02895-6510
US

V. Phone/Fax

Practice location:
  • Phone: 401-324-9100
  • Fax:
Mailing address:
  • Phone: 401-324-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: