Provider Demographics
NPI:1497763726
Name:REED, KATHLEEN DAWN (MED LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:DAWN
Last Name:REED
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:BEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 REED RD
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-1366
Mailing Address - Country:US
Mailing Address - Phone:817-408-7687
Mailing Address - Fax:
Practice Address - Street 1:1101 WATERS EDGE DR
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-1474
Practice Address - Country:US
Practice Address - Phone:817-408-7687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26585703OtherAMERIGROUP
TX6234LCOtherBCBS
TX2188571OtherCIGNA
TX223926OtherCOMPSYCH