Provider Demographics
NPI:1235627068
Name:REESE, JADA (PLPC)
Entity Type:Individual
Prefix:
First Name:JADA
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9834 SHEPHERDS CIR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-3276
Mailing Address - Country:US
Mailing Address - Phone:816-500-5009
Mailing Address - Fax:
Practice Address - Street 1:300 E 36TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1410
Practice Address - Country:US
Practice Address - Phone:816-508-1700
Practice Address - Fax:816-508-1757
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018007373101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional