Provider Demographics
NPI:1801513619
Name:REED, KELLY MCGREGOR (LPC-A, LCDC-I)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:MCGREGOR
Last Name:REED
Suffix:
Gender:F
Credentials:LPC-A, LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11316 VALLEYDALE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3228
Mailing Address - Country:US
Mailing Address - Phone:214-537-1889
Mailing Address - Fax:
Practice Address - Street 1:2010 AL LIPSCOMB WAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-2773
Practice Address - Country:US
Practice Address - Phone:214-421-6705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87476101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health