Provider Demographics
NPI:1770230542
Name:REED, SHANIKA ALICIA
Entity Type:Individual
Prefix:
First Name:SHANIKA
Middle Name:ALICIA
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 175TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2076
Mailing Address - Country:US
Mailing Address - Phone:773-998-9948
Mailing Address - Fax:
Practice Address - Street 1:905 175TH ST FL 3
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2076
Practice Address - Country:US
Practice Address - Phone:773-998-9948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health