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General NPI Number Information
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NPI Number | 1073755526
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Entity Type | Individual
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Provider Name | ANDREA REED LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 4615 E STATE ST STE 202
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City | ROCKFORD
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State | IL
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Zip | 61108-2158
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Country | US
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Telephone | 847-868-3435
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Fax | 847-859-5885
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Provider Business Mailing Address
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Address Line | 4215 HIGHCREST RD
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City | ROCKFORD
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State | IL
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Zip | 61107-2107
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Country | US
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Telephone | 815-670-2029
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178014750
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180016317
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License Number State | IL
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