Provider Demographics
NPI:1033280755
Name:REED, PETER (LICSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:REED
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HALE ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4634
Mailing Address - Country:US
Mailing Address - Phone:978-927-2787
Mailing Address - Fax:
Practice Address - Street 1:10 HARBOR ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3390
Practice Address - Country:US
Practice Address - Phone:978-741-0140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10241681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1895567Medicaid
MA463528OtherTUFTS BENEFIT ADMINISTRAT
MA043114833-06OtherPACIFICARE BEHAVIORAL HEA
MA015171OtherVALUE OPTIONS
MAP08076OtherBCBS FEDERAL OF MA
MAP08076OtherMEDEX
MA463528OtherTUFTS HEALTH PLAN
MAP08076OtherBCBS OF MA