Provider Demographics
NPI:1053873653
Name:PEACEFUL CONNECTIONS THERAPY, PLLC
Entity type:Organization
Organization Name:PEACEFUL CONNECTIONS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:REEDY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-S, LMFT-S
Authorized Official - Phone:512-228-9095
Mailing Address - Street 1:107 FANNIN AVE BLDG 100
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-5218
Mailing Address - Country:US
Mailing Address - Phone:512-228-9095
Mailing Address - Fax:
Practice Address - Street 1:107 FANNIN AVE BLDG 100
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5218
Practice Address - Country:US
Practice Address - Phone:512-228-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty