Provider Demographics
NPI:1194788133
Name:REED, ANDREW J (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:REED
Suffix:
Gender:M
Credentials:PHD
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 15040
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-0040
Mailing Address - Country:US
Mailing Address - Phone:812-476-1367
Mailing Address - Fax:812-477-4153
Practice Address - Street 1:6221 PHYSICIANS CT
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4031
Practice Address - Country:US
Practice Address - Phone:812-454-5457
Practice Address - Fax:812-471-9282
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040384103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN680014742OtherRR MCARE PRIVATE PRACTICE
IN100447430AMedicaid
KY89000459Medicaid
IN360003673OtherRR MCARE THERAPY
IN179950Medicare PIN
IN360003673OtherRR MCARE THERAPY
IN680014742OtherRR MCARE PRIVATE PRACTICE
INR93078Medicare UPIN