Provider Demographics
NPI:1033504634
Name:REESE, FELICIA (MS LCAS-A)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:MS LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 N POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-3354
Mailing Address - Country:US
Mailing Address - Phone:336-266-1815
Mailing Address - Fax:
Practice Address - Street 1:962 S FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6591
Practice Address - Country:US
Practice Address - Phone:336-266-1815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-21758101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)