Provider Demographics
NPI:1427509470
Name:REED, JESSICA (MHC-LP, CASAC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:MHC-LP, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1369 BROADWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7200
Mailing Address - Country:US
Mailing Address - Phone:212-268-8830
Mailing Address - Fax:212-947-2424
Practice Address - Street 1:1369 BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-7200
Practice Address - Country:US
Practice Address - Phone:212-268-8830
Practice Address - Fax:212-947-2424
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31964101YA0400X
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)