1033280755 NPI number — MR. PETER REED LICSW

Table of content: MR. PETER REED LICSW (NPI 1033280755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033280755 NPI number — MR. PETER REED LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REED
Provider First Name:
PETER
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
M

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:
1033280755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 HALE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEVERLY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01915-4634
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-927-2787
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 HARBOR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVERS
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01923-3390
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-741-0140
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2006

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:  1024168 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1895567 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 463528 . This is a "TUFTS BENEFIT ADMINISTRAT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043114833-06 . This is a "PACIFICARE BEHAVIORAL HEA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 015171 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P08076 . This is a "BCBS FEDERAL OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P08076 . This is a "MEDEX" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 463528 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P08076 . This is a "BCBS OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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