Healthcare Provider Details

I. General information

NPI: 1003176405
Provider Name (Legal Business Name): REED CENTER FOR WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6797 N HIGH ST SUITE 212
WORTHINGTON OH
43085-2533
US

IV. Provider business mailing address

165 W CENTER ST STE 205
MARION OH
43302-3741
US

V. Phone/Fax

Practice location:
  • Phone: 614-505-7049
  • Fax:
Mailing address:
  • Phone: 614-505-7049
  • Fax: 800-552-0838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.0500182
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0500182
License Number StateOH

VIII. Authorized Official

Name: MS. NANCY J PELPHREY
Title or Position: MENTAL HEALTH COUNSELOR
Credential: RN, PCC
Phone: 614-505-7049