Provider Demographics
NPI:1356660344
Name:REED, RICHALE R (MA LPC LCAS)
Entity Type:Individual
Prefix:MRS
First Name:RICHALE
Middle Name:R
Last Name:REED
Suffix:
Gender:F
Credentials:MA LPC LCAS
Other - Prefix:
Other - First Name:RICHALE
Other - Middle Name:
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:351 WAGONER DRIVE
Mailing Address - Street 2:SUITE 334
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303
Mailing Address - Country:US
Mailing Address - Phone:336-355-7237
Mailing Address - Fax:888-550-2894
Practice Address - Street 1:351 WAGONER DRIVE
Practice Address - Street 2:SUITE 334
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303
Practice Address - Country:US
Practice Address - Phone:336-355-7237
Practice Address - Fax:888-550-2804
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-31
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10534101Y00000X, 101YP2500X, 101YM0800X
NC14414101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional