Provider Demographics
NPI:1699375121
Name:REED, DEANNA L (LSW)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:L
Last Name:REED
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:L
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:0N815 MA CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60119
Mailing Address - Country:US
Mailing Address - Phone:608-669-0879
Mailing Address - Fax:
Practice Address - Street 1:23819 W MILL ST STE 9
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-3460
Practice Address - Country:US
Practice Address - Phone:331-248-2416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.104553104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker