Healthcare Provider Details

I. General information

NPI: 1396229845
Provider Name (Legal Business Name): KELLY J REED LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4238 WASHINGTON ST STE 314
BOSTON MA
02131-2558
US

IV. Provider business mailing address

4238 WASHINGTON ST STE 314
BOSTON MA
02131-2558
US

V. Phone/Fax

Practice location:
  • Phone: 857-275-5624
  • Fax:
Mailing address:
  • Phone: 857-275-5624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number800
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number112037
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: