Provider Demographics
NPI:1669953139
Name:REED, BRADLEY DEAN (MA, NCC, LMHC)
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:DEAN
Last Name:REED
Suffix:
Gender:M
Credentials:MA, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9309 NE 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-5323
Mailing Address - Country:US
Mailing Address - Phone:360-356-5890
Mailing Address - Fax:
Practice Address - Street 1:717 NE 61ST ST STE 202
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8756
Practice Address - Country:US
Practice Address - Phone:360-718-6548
Practice Address - Fax:360-718-6554
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61033546101YM0800X
COLPP.0001515101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional