Jack Reid, PCCI #1189

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PCCI 1189 Issued in CA

Practice address

110 Gough St
Suite 202
San Francisco, CA 94102-5945

Phone

(415) 944-3628

NPI assigned

Nov 28, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jay Reid Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1811394364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 GOUGH ST",
            "address_2": "SUITE 202",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025945",
            "telephone_number": "415-944-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 GOUGH ST",
            "address_2": "SUITE 202",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025945",
            "telephone_number": "415-944-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "JACK",
        "credential": "PCCI #1189",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-28",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PCCI 1189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "REID",
            "credential": "PCCI #1189",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lindsey Katelynn Reichman, MSW, PPS-SP
• Amanda Elizabeth Reichmuth
• Colette A Reid Horn, MSW, LCSW
• Catherine Ann Reid, LCSW
• Colton R Reid, FNP-C
• Jennifer Elizabeth Reid, M.D.
• Kristen W. Reid, M.D.
• Marq'Uis Amari-Hakeem Reid
• Michael J Reid, M. D.
• Michael J a Reid, MD

• Mental Health Counselor in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.