Provider Demographics
NPI:1275613101
Name:REED, ALEXIS SR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ALEXIS
Middle Name:
Last Name:REED
Suffix:SR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 SE COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-3094
Mailing Address - Country:US
Mailing Address - Phone:816-721-1570
Mailing Address - Fax:
Practice Address - Street 1:4045 NE LAKEWOOD WAY STE 130
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1995
Practice Address - Country:US
Practice Address - Phone:816-886-2184
Practice Address - Fax:816-886-2397
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040244881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA3453Medicare PIN