Provider Demographics
NPI:1285633040
Name:REEVE, RONALD E (PHD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:E
Last Name:REEVE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 EMMET STREET, SOUTH
Mailing Address - Street 2:P.O. BOX 400270
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22904-4270
Mailing Address - Country:US
Mailing Address - Phone:434-924-7034
Mailing Address - Fax:434-924-4621
Practice Address - Street 1:417 EMMET STREET, SOUTH
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22904-4270
Practice Address - Country:US
Practice Address - Phone:434-924-7034
Practice Address - Fax:434-924-4621
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002364103TC0700X
VA0803000051103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007706359Medicaid
VA007706359Medicaid