Provider Demographics
NPI:1467923169
Name:REED, JODY MICHELE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:MICHELE
Last Name:REED
Suffix:
Gender:F
Credentials:MA, 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 405
Mailing Address - Street 2:
Mailing Address - City:DOBBIN
Mailing Address - State:TX
Mailing Address - Zip Code:77333-0405
Mailing Address - Country:US
Mailing Address - Phone:281-780-2425
Mailing Address - Fax:
Practice Address - Street 1:6360 HONEA EGYPT RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316
Practice Address - Country:US
Practice Address - Phone:281-780-2425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16253101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health