Healthcare Provider Details

I. General information

NPI: 1164259073
Provider Name (Legal Business Name): KELLEY S REED LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N GLEBE RD
ARLINGTON VA
22203-3728
US

IV. Provider business mailing address

200 N GLEBE RD STE 104
ARLINGTON VA
22203-3755
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-0703
  • Fax:
Mailing address:
  • Phone: 757-375-3675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200003411
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904015192
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: