Healthcare Provider Details

I. General information

NPI: 1184701393
Provider Name (Legal Business Name): JOHN HOWE REED SR. MS LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 EXETER RD
LEBANON CT
06249-1544
US

IV. Provider business mailing address

525 EXETER RD
LEBANON CT
06249-1544
US

V. Phone/Fax

Practice location:
  • Phone: 860-303-9540
  • Fax: 860-642-9944
Mailing address:
  • Phone: 860-303-9540
  • Fax: 860-642-9944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000611
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: