Provider Demographics
NPI:1205311123
Name:REED, KIRA MARIE (LCSW 111380)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:MARIE
Last Name:REED
Suffix:
Gender:F
Credentials:LCSW 111380
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-3221
Mailing Address - Country:US
Mailing Address - Phone:661-243-0575
Mailing Address - Fax:
Practice Address - Street 1:21380 CENTRE POINTE PKWY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-3050
Practice Address - Country:US
Practice Address - Phone:661-243-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1113801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical