1770171993 NPI number — KAREN REED LICSW

Table of content: KAREN REED LICSW (NPI 1770171993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770171993 NPI number — KAREN REED LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REED
Provider First Name:
KAREN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770171993
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8006 OAT CHASE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOWIE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20715-4623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-758-6731
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11821 PARKLAWN DR STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20852-2539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-650-5943
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LC50082047 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LC50080658 . This is a "LICSW" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 15773 . This is a "LMSW" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".