MEDICARE: DANIELLE A REED LCSW PLLC

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	1041C0700X	Clinical Social Worker	LCSW12155	AZ

General Provider Information

NPI Number	:	1619019346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIELLE A REED LCSW PLLC

Provider Business Mailing Address
First Line	:	9784 W YEARLING RD
Second Line	:	STE B-1580
City	:	PEORIA
State	:	AZ
Zip	:	85383-1379
Country	:	US
Telephone Number	:	623-825-1777
Fax Number	:	623-825-6757

Provider Business Practice Location Address
First Line	:	9784 W YEARLING RD
Second Line	:	STE B-1580
City	:	PEORIA
State	:	AZ
Zip	:	85383-1379
Country	:	US
Telephone Number	:	623-825-1777
Fax Number	:	623-825-6757

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIELLE A REED
Credential	:	LCSW
Telephone Number	:	623-825-1777

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	04/16/2009

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