Provider Demographics
NPI:1205913399
Name:REED, JILL SUSAN (LMSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:SUSAN
Last Name:REED
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 BLUE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-7270
Mailing Address - Country:US
Mailing Address - Phone:828-682-2111
Mailing Address - Fax:
Practice Address - Street 1:72 BLUE RIDGE LN
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-7270
Practice Address - Country:US
Practice Address - Phone:828-682-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0077731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical