Provider Demographics
NPI:1407150527
Name:REINSTEDT, BRUCE (LPC)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:REINSTEDT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7448
Mailing Address - Country:US
Mailing Address - Phone:541-774-7915
Mailing Address - Fax:
Practice Address - Street 1:1005 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7448
Practice Address - Country:US
Practice Address - Phone:541-774-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health