Provider Demographics
NPI:1144570722
Name:REEVES, LAUREN BETH (MS)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BETH
Last Name:REEVES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 FLORIDA CENTRAL PKWY
Mailing Address - Street 2:SUITE 1028
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-7651
Mailing Address - Country:US
Mailing Address - Phone:407-774-2284
Mailing Address - Fax:407-774-2285
Practice Address - Street 1:740 FLORIDA CENTRAL PKWY
Practice Address - Street 2:SUITE 1028
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-7651
Practice Address - Country:US
Practice Address - Phone:407-774-2284
Practice Address - Fax:407-774-2285
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMHT8003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health