Provider Demographics
NPI:1386862589
Name:REED, JD JR (COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:JD
Middle Name:
Last Name:REED
Suffix:JR
Gender:M
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E BENNETT ST APT 17
Mailing Address - Street 2:P.O. BOX 4023
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-4939
Mailing Address - Country:US
Mailing Address - Phone:310-594-4823
Mailing Address - Fax:310-639-0119
Practice Address - Street 1:544 W ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90222-3944
Practice Address - Country:US
Practice Address - Phone:310-639-0107
Practice Address - Fax:310-639-0119
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190466AN101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)