Basic Information
| Provider Information | |||||||||
| NPI: | 1376008771 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | COREY | ||||||||
| MiddleName: | B. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1344 N PETERSON AVE | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672124229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3163936750 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 N LORRAINE ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | HUTCHINSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 675015600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206637595 | ||||||||
| FaxNumber: | 6205135098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2019 | ||||||||
| LastUpdateDate: | 03/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 2363 | KS | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.