Provider Demographics
NPI:1992084305
Name:REED, GARY MERLE (LPC)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:MERLE
Last Name:REED
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7955 BIG BEND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2703
Mailing Address - Country:US
Mailing Address - Phone:314-968-2216
Mailing Address - Fax:314-968-2335
Practice Address - Street 1:7955 BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-2703
Practice Address - Country:US
Practice Address - Phone:314-968-2216
Practice Address - Fax:314-968-2335
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001774101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional