Provider Demographics
NPI:1225239080
Name:REED, KATHLEEN TERESE (MED, PCC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:TERESE
Last Name:REED
Suffix:
Gender:F
Credentials:MED, PCC
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:TERESE
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCC
Mailing Address - Street 1:131 N EWING ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3383
Mailing Address - Country:US
Mailing Address - Phone:740-689-6700
Mailing Address - Fax:
Practice Address - Street 1:131 N EWING ST
Practice Address - Street 2:SUITE B
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3383
Practice Address - Country:US
Practice Address - Phone:740-689-6700
Practice Address - Fax:740-689-6702
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0500295101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional