Provider Demographics
NPI:1225556418
Name:REED, LOUIS L (LADC, CAC)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:L
Last Name:REED
Suffix:
Gender:M
Credentials:LADC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06607-2220
Mailing Address - Country:US
Mailing Address - Phone:860-503-6423
Mailing Address - Fax:
Practice Address - Street 1:3334 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-4227
Practice Address - Country:US
Practice Address - Phone:203-493-1086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001232101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)