Healthcare Provider Details

I. General information

NPI: 1619943925
Provider Name (Legal Business Name): PAMELA ARLENE REED PSYD, HSPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 04/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13965 N STATE ROAD 67
CAMBY IN
46113-8354
US

IV. Provider business mailing address

13965 N STATE ROAD 67
CAMBY IN
46113-8354
US

V. Phone/Fax

Practice location:
  • Phone: 317-831-2686
  • Fax: 317-831-2669
Mailing address:
  • Phone: 317-831-2686
  • Fax: 317-831-2669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39000453A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20042119A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: