Provider Demographics
NPI:1649562885
Name:REED, ELIZABETH DAWN (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:DAWN
Last Name:REED
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 HORSESHOE RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-8507
Mailing Address - Country:US
Mailing Address - Phone:740-238-0837
Mailing Address - Fax:
Practice Address - Street 1:117 COWPEN NECK RD
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-9184
Practice Address - Country:US
Practice Address - Phone:252-335-2018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-06
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009436121041C0700X
VA09040116291041C0700X
NCC0094701041C0700X
OHI.0027648-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH12236675OtherNPI