Provider Demographics
NPI:1902403744
Name:REED, PHADRIA ENRIKA (LCDC, PLPC)
Entity Type:Individual
Prefix:MS
First Name:PHADRIA
Middle Name:ENRIKA
Last Name:REED
Suffix:
Gender:F
Credentials:LCDC, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1253
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8149
Mailing Address - Country:US
Mailing Address - Phone:214-424-9750
Mailing Address - Fax:
Practice Address - Street 1:451 WILSON CREEK BLVD APT 1217
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-6462
Practice Address - Country:US
Practice Address - Phone:214-424-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13669101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)