Provider Demographics
NPI:1467510362
Name:REED, WAYNE GILL JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:GILL
Last Name:REED
Suffix:JR
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:PO BOX 633
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-0633
Mailing Address - Country:US
Mailing Address - Phone:757-569-0007
Mailing Address - Fax:757-569-0011
Practice Address - Street 1:100 FAIRVIEW DR
Practice Address - Street 2:SUITE 200-B
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1238
Practice Address - Country:US
Practice Address - Phone:757-569-0007
Practice Address - Fax:757-569-0011
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003254101YM0800X
NC3450101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA261218OtherCOMPSYCH
VA186337OtherANTHEM BCBS PPO AND HMO
VA548467OtherVALUE OPTIONS