Healthcare Provider Details

I. General information

NPI: 1164259073
Provider Name (Legal Business Name): KELLEY S REED LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PENNSYLVANIA AVE SE STE 201
WASHINGTON DC
20003-2152
US

IV. Provider business mailing address

801 PENNSYLVANIA AVE SE STE 201
WASHINGTON DC
20003-2152
US

V. Phone/Fax

Practice location:
  • Phone: 202-546-1512
  • Fax:
Mailing address:
  • Phone: 202-546-1512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200003411
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904015192
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: