Provider Demographics
NPI:1982174892
Name:REED, JAY ALEXANDRA (LCSW)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:ALEXANDRA
Last Name:REED
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5285 RIVER BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:FORT DENAUD
Mailing Address - State:FL
Mailing Address - Zip Code:33935-0604
Mailing Address - Country:US
Mailing Address - Phone:239-784-3211
Mailing Address - Fax:
Practice Address - Street 1:10471 6 MILE CYPRESS PKWY STE 4011
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-6973
Practice Address - Country:US
Practice Address - Phone:239-675-3038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical