Provider Demographics
NPI:1760761787
Name:REED, KERRY RONALD (LPC)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:RONALD
Last Name:REED
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:PA
Mailing Address - Zip Code:15627-1907
Mailing Address - Country:US
Mailing Address - Phone:724-205-9759
Mailing Address - Fax:
Practice Address - Street 1:13380 STATE ROUTE 30
Practice Address - Street 2:SUITE 5
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-1125
Practice Address - Country:US
Practice Address - Phone:724-205-9759
Practice Address - Fax:724-515-7238
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005973101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional