Individual provider Active NPI

Kevin R Reeder, PH.D.

  • Counseling Psychologist
  • North Little Rock, AR
National Provider Identifier
1245247824
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
2200 Fort Roots Dr
North Little Rock, AR 72114-1709
Phone
(615) 542-3080
NPI assigned
Aug 3, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Counseling Psychologist 103TC1900X Primary

Addresses

Primary practice location

2200 Fort Roots Dr
North Little Rock, AR 72114-1709

Mailing address

425 Mimosa Dr
Saint Simons Island, GA 31522-5800
Phone (615) 542-3080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1245247824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MIMOSA DR",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315225800",
            "telephone_number": "615-542-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FORT ROOTS DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721141709",
            "telephone_number": "615-542-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "KEVIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.