Healthcare Provider Details

I. General information

NPI: 1801659735
Provider Name (Legal Business Name): LIBERTY REED PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 CYPRESS CREEK RD STE 201
CEDAR PARK TX
78613-4468
US

IV. Provider business mailing address

1209 RAWHIDE TRL
CEDAR PARK TX
78613-3923
US

V. Phone/Fax

Practice location:
  • Phone: 512-461-3970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ERIN TIRRELL WHITE
Title or Position: FOUNDER & DIRECTOR
Credential: LPC-S, RPT-S
Phone: 512-461-3970