Provider Demographics
NPI:1366214504
Name:REED, SHIROME (PROVIDER)
Entity type:Individual
Prefix:
First Name:SHIROME
Middle Name:
Last Name:REED
Suffix:
Gender:M
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10665 STANHAVEN PL
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3055
Mailing Address - Country:US
Mailing Address - Phone:443-992-0069
Mailing Address - Fax:
Practice Address - Street 1:10665 STANHAVEN PL
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3055
Practice Address - Country:US
Practice Address - Phone:443-992-0069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD250316344101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)