Provider Demographics
NPI:1457848350
Name:REED, CHARLES B III (MA, MDIV, LPCA)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:B
Last Name:REED
Suffix:III
Gender:M
Credentials:MA, MDIV, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 OLEANDER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-4599
Mailing Address - Country:US
Mailing Address - Phone:919-243-1505
Mailing Address - Fax:
Practice Address - Street 1:34 OLEANDER DR STE 104
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-4599
Practice Address - Country:US
Practice Address - Phone:919-243-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13847101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health