Provider Demographics
NPI:1285027052
Name:REED, JENNIFER (LPCC-S, ATR)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:LPCC-S, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3681 GREEN RD STE 404
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5716
Mailing Address - Country:US
Mailing Address - Phone:216-342-5484
Mailing Address - Fax:
Practice Address - Street 1:3681 GREEN RD STE 404
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5716
Practice Address - Country:US
Practice Address - Phone:216-342-5484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1400402-TRNE101YM0800X
OHE.1700257-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2844093Medicaid