Individual
COLLEEN LOUISE REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, LCASA
Contact information
Practice address
3505 N ROXBORO ST, DURHAM, NC 27704-2767
(919) 220-4224
Mailing address
1502 W NC HIGHWAY 54, STE 103, DURHAM, NC 27707-5572
(919) 354-0840
(919) 748-4441
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-22966
NC
1041C0700X
Clinical Social Worker
Primary
C011863
NC
Other
Enumeration date
11/10/2018
Last updated
11/19/2018
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