Provider Demographics
NPI:1982753414
Name:REED, PETER W (LMHC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:W
Last Name:REED
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1053
Mailing Address - Street 2:
Mailing Address - City:RILEY
Mailing Address - State:IN
Mailing Address - Zip Code:47871-1053
Mailing Address - Country:US
Mailing Address - Phone:812-894-2433
Mailing Address - Fax:
Practice Address - Street 1:7469 STATE ROAD 46
Practice Address - Street 2:
Practice Address - City:RILEY
Practice Address - State:IN
Practice Address - Zip Code:47871-1053
Practice Address - Country:US
Practice Address - Phone:812-894-2433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001633A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health