Provider Demographics
NPI:1700451192
Name:REED, REGINA MARIE (LPC-MHSP (T))
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:MARIE
Last Name:REED
Suffix:
Gender:F
Credentials:LPC-MHSP (T)
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:REED
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10414 JACKSON OAKS WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-0704
Mailing Address - Country:US
Mailing Address - Phone:865-671-3232
Mailing Address - Fax:
Practice Address - Street 1:10414 JACKSON OAKS WAY STE 103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-0704
Practice Address - Country:US
Practice Address - Phone:865-309-5044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health