Kourtney Reed, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

105533-1 Issued in NY

Practice address

63 Havenwood Dr
Brockport, NY 14420-1756

Phone

(585) 362-0991

NPI assigned

Mar 16, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1043846645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 HAVENWOOD DR",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201756",
            "telephone_number": "585-362-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 HAVENWOOD DR",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201756",
            "telephone_number": "585-362-0991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Portland Ave Ste 445",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213022",
            "country_code": "US",
            "telephone_number": "585-698-0530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REED",
        "first_name": "KOURTNEY",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "105533-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Lee Raff, OD
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• Linda Ranalletti, RDH
• Timothy Rawcliffe
• Alison Elizabeth Reigle, MS
• Danielle Renodin-Mead, DO
• Alicia Marie Rich, OPTICIAN
• John P Risolo, M.D.
• Rite Aid of New York Inc

• Social Worker in Brockport, NY
• Providers in Brockport, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.