Healthcare Provider Details

I. General information

NPI: 1891616553
Provider Name (Legal Business Name): LEANNA GENTRY REED LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 W LEBANON ST APT 306
MOUNT AIRY NC
27030-2954
US

IV. Provider business mailing address

335 WILLOW ST APT 306
MOUNT AIRY NC
27030-3998
US

V. Phone/Fax

Practice location:
  • Phone: 336-789-9492
  • Fax:
Mailing address:
  • Phone: 336-469-9789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP024204
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: