Provider Demographics
NPI:1437205606
Name:MCLEOD, KENNETH REAMS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:REAMS
Last Name:MCLEOD
Suffix:
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 1:7842 OAKINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2119
Mailing Address - Country:US
Mailing Address - Phone:713-981-0412
Mailing Address - Fax:
Practice Address - Street 1:4200 MONTROSE BLVD STE 540
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5460
Practice Address - Country:US
Practice Address - Phone:713-522-7014
Practice Address - Fax:713-522-1186
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
611308Medicare ID - Type UnspecifiedINDIVUDAL NUMBER