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NPI Code Detail

MEDICARE: DIANE REAS LICSW

MEDICARE:   DIANE  REAS  LICSW
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
11041C0700XClinical Social Worker1142794MA

General Provider Information

NPI Number : 1982818654
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE REAS LICSW
Provider Business Mailing Address
First Line : PO BOX 675153
Second Line :
City : DETROIT
State : MI
Zip : 48267-5153
Country : US
Telephone Number : 781-551-0999
Fax Number :
Provider Business Practice Location Address
First Line : 11 MIDSTATE DR STE 3
Second Line :
City : AUBURN
State : MA
Zip : 01501-1882
Country : US
Telephone Number : 781-551-0999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 12/03/2025

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Directions to “ DIANE REAS LICSW” Practice Location

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