Provider Demographics
NPI:1194543983
Name:REED, TARAN TYESE (LPC-A)
Entity type:Individual
Prefix:
First Name:TARAN
Middle Name:TYESE
Last Name:REED
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 BEDFORDSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-1436
Mailing Address - Country:US
Mailing Address - Phone:217-791-3278
Mailing Address - Fax:
Practice Address - Street 1:4101 MCEWEN RD STE 255
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5272
Practice Address - Country:US
Practice Address - Phone:214-468-4385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96465101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor