Provider Demographics
NPI:1235482571
Name:REED, TERESA LYNNE (LLMSW)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNNE
Last Name:REED
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-1134
Mailing Address - Country:US
Mailing Address - Phone:810-686-7313
Mailing Address - Fax:810-686-7315
Practice Address - Street 1:740 CENTER ST
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420-1134
Practice Address - Country:US
Practice Address - Phone:810-686-7313
Practice Address - Fax:810-686-7315
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010946031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical