=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467510362
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WAYNE GILL REED JR. LPC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 FAIRVIEW DR SUITE 200-B
-----------------------------------------------------
City | FRANKLIN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23851-1238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-569-0007
-----------------------------------------------------
Fax | 757-569-0011
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 633
-----------------------------------------------------
City | FRANKLIN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23851-0633
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-569-0007
-----------------------------------------------------
Fax | 757-569-0011
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 0701003254
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 3450
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------