MEDICARE: NOEL REID LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6407-C	NV

General Provider Information

NPI Number	:	1467754424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOEL REID LCSW

Provider Business Mailing Address
First Line	:	3047 E WARM SPRINGS RD
Second Line	:	BUILDING 2, SUITE #400
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3760
Country	:	US
Telephone Number	:	702-241-5739
Fax Number	:	702-684-7046

Provider Business Practice Location Address
First Line	:	3047 E WARM SPRINGS RD
Second Line	:	BUILDING 2, SUITE #400
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3760
Country	:	US
Telephone Number	:	702-241-5739
Fax Number	:	702-684-7046

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2010
Last Update Date	:	01/07/2015

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