Provider Demographics
NPI:1073121612
Name:REEVES, TYREE BERNARD (MSW)
Entity Type:Individual
Prefix:
First Name:TYREE
Middle Name:BERNARD
Last Name:REEVES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1742
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-7522
Mailing Address - Country:US
Mailing Address - Phone:678-200-8420
Mailing Address - Fax:
Practice Address - Street 1:650 HENDERSON DR STE 406
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3758
Practice Address - Country:US
Practice Address - Phone:770-334-2493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker