Provider Demographics
NPI:1568899870
Name:REED, KALISHA L (LICENSED INDEPENDANT)
Entity Type:Individual
Prefix:MS
First Name:KALISHA
Middle Name:L
Last Name:REED
Suffix:
Gender:F
Credentials:LICENSED INDEPENDANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 TUCKER ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-2285
Mailing Address - Country:US
Mailing Address - Phone:402-980-0369
Mailing Address - Fax:
Practice Address - Street 1:2101 S 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2947
Practice Address - Country:US
Practice Address - Phone:402-553-3000
Practice Address - Fax:402-552-7497
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1408101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health