Healthcare Provider Details

I. General information

NPI: 1740303874
Provider Name (Legal Business Name): DEXTER BENTLEY REED L.I.S.W
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 PENNSYLVANIA AVE SE
WASHINGTON DC
20020-3865
US

IV. Provider business mailing address

8712 COLESVILLE RD
SILVER SPRING MD
20910-3920
US

V. Phone/Fax

Practice location:
  • Phone: 202-581-2455
  • Fax:
Mailing address:
  • Phone: 240-643-5379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLI200105
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: