Individual provider Active NPI

Logan Reed

  • Mental Health Counselor
  • Cherry Hill, NJ
National Provider Identifier
1275995185
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37AC00505300 Issued in NJ
Practice address
1873 Marlton Pike E Ste 2-C
Cherry Hill, NJ 08003-2012
Phone
(732) 982-2888
Fax
(847) 859-5885
NPI assigned
Mar 22, 2016
Last updated
Sep 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37AC00505300 NJ Primary

Addresses

Primary practice location

1873 Marlton Pike E Ste 2-C
Cherry Hill, NJ 08003-2012

Mailing address

175 E Hawthorn Pkwy Ste 235
Vernon Hills, IL 60061-1454
Phone (847) 868-3435

Other practice location 1

90 W Afton Ave
Suite 101
Yardley, PA 19067-1421
Phone (877) 636-9322 ext. 100

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

State licenses

LicenseStateTypeSpecialty
37AC00505300NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
PHC of Buffalo Grove Clinical Psychology CurrentSince Sep 20, 2020 Accepting new patients
Life of Purpose - Pennsylvania Past Accepting new patients
New Jersey Behavioral Health P.C PastSince Sep 20, 2020 Accepting new patients

Locations

175 E Hawthorne Pkwy
Ste 235
Vernon Hills, IL 60061
Phone (847) 865-4125

1873 Marlton Pike E
Ste 2-C
Cherry Hill, NJ 08003

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.loganreed@148376.advancedmd-direct.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1275995185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HAWTHORN PKWY STE 235",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611454",
            "telephone_number": "847-868-3435",
            "fax_number": "847-859-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 MARLTON PIKE E STE 2-C",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032012",
            "telephone_number": "732-982-2888",
            "fax_number": "847-859-5885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 W Afton Ave",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Yardley",
            "state": "PA",
            "postal_code": "190671421",
            "country_code": "US",
            "telephone_number": "877-636-9322 x100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REED",
        "first_name": "LOGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00505300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.