Provider Demographics
NPI:1972013423
Name:REED, MISTY LYNN (BS, BS, MS MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:MISTY
Middle Name:LYNN
Last Name:REED
Suffix:
Gender:F
Credentials:BS, BS, MS MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 YOUREE DRIVE
Mailing Address - Street 2:1800A
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105
Mailing Address - Country:US
Mailing Address - Phone:504-210-9880
Mailing Address - Fax:
Practice Address - Street 1:1717 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101
Practice Address - Country:US
Practice Address - Phone:318-226-9944
Practice Address - Fax:318-226-9942
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health