Provider Demographics
NPI:1043530975
Name:REED, MICHAEL (LPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
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 1:990 VILLA ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-1236
Mailing Address - Country:US
Mailing Address - Phone:888-688-9296
Mailing Address - Fax:888-688-9296
Practice Address - Street 1:2024 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-2758
Practice Address - Country:US
Practice Address - Phone:918-682-9292
Practice Address - Fax:918-682-0054
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
COLPC.0020061101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator