MEDICARE: MRS. RICHALE R REED MA LCMHCS LCAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	10534	NC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	14414	NC
3	101YP2500X	Professional Counselor	10534	NC
4	101YM0800X	Mental Health Counselor	10534	NC

General Provider Information

NPI Number	:	1356660344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RICHALE R REED MA LCMHCS LCAS

Provider Business Mailing Address
First Line	:	1930 CLUB POND RD # 1015
Second Line	:
City	:	RAEFORD
State	:	NC
Zip	:	28376-8691
Country	:	US
Telephone Number	:	910-323-3368
Fax Number	:	910-486-7000

Provider Business Practice Location Address
First Line	:	1930 CLUB POND RD # 1015
Second Line	:
City	:	RAEFORD
State	:	NC
Zip	:	28376-8691
Country	:	US
Telephone Number	:	910-323-3368
Fax Number	:	910-486-7000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2010
Last Update Date	:	05/21/2024

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