Provider Demographics
NPI:1750905253
Name:REED, KATHLENA N (MA)
Entity type:Individual
Prefix:MRS
First Name:KATHLENA
Middle Name:N
Last Name:REED
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KATHLENA
Other - Middle Name:N
Other - Last Name:WHITEHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2425 NE 115TH AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34488-2527
Mailing Address - Country:US
Mailing Address - Phone:352-433-7557
Mailing Address - Fax:
Practice Address - Street 1:4131 UNIVERSITY BLVD S FL 32216
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4326
Practice Address - Country:US
Practice Address - Phone:904-745-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty