Provider Demographics
NPI:1053804252
Name:ALI REED, ENID MAHASIN (LLPC)
Entity type:Individual
Prefix:MRS
First Name:ENID
Middle Name:MAHASIN
Last Name:ALI REED
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:MRS
Other - First Name:ENID
Other - Middle Name:MAHASIN
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:23525 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3153
Mailing Address - Country:US
Mailing Address - Phone:313-443-4721
Mailing Address - Fax:
Practice Address - Street 1:29556 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2021
Practice Address - Country:US
Practice Address - Phone:248-595-7410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016340101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health