Provider Demographics
NPI:1083605182
Name:REEDY, MARILYN HYLAND (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:HYLAND
Last Name:REEDY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BAYSTATE CT
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-2120
Mailing Address - Country:US
Mailing Address - Phone:508-240-7964
Mailing Address - Fax:508-240-5448
Practice Address - Street 1:149 GREAT WESTERN RD
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-2400
Practice Address - Country:US
Practice Address - Phone:508-432-4649
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health