Provider Demographics
NPI:1508666413
Name:REED, TAMELA RAE (LISW-CP)
Entity type:Individual
Prefix:
First Name:TAMELA
Middle Name:RAE
Last Name:REED
Suffix:
Gender:
Credentials:LISW-CP
Other - Prefix:
Other - First Name:TAMELA
Other - Middle Name:RAE
Other - Last Name:PANTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:112 W 4TH NORTH ST STE B
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6447
Mailing Address - Country:US
Mailing Address - Phone:843-708-9764
Mailing Address - Fax:
Practice Address - Street 1:112 W 4TH NORTH ST STE B
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6447
Practice Address - Country:US
Practice Address - Phone:843-708-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC115171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical