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General NPI Number Information
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NPI Number | 1376377796
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Entity Type | Individual
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Provider Name | BA'LANCE REED
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Gender | Male
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Dates
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Enumeration Date | 08/28/2024
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 2000 S PROMENADE BLVD STE 202
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City | ROGERS
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State | AR
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Zip | 72758-8609
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Country | US
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Telephone | 479-408-4197
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Fax | 888-977-2956
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Provider Business Mailing Address
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Address Line | 1707 LINWOOD DR STE B
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City | PARAGOULD
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State | AR
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Zip | 72450-5365
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Country | US
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Telephone | 870-604-4455
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Fax | 888-977-2956
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A2408010
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A2408010
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License Number State | AR
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