Provider Demographics
NPI:1316029523
Name:REESE, LINDA P (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:P
Last Name:REESE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:P
Other - Last Name:MORROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 33458
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903
Mailing Address - Country:US
Mailing Address - Phone:321-723-7300
Mailing Address - Fax:321-773-0322
Practice Address - Street 1:2194 HIGHWAY A1A
Practice Address - Street 2:STE 309
Practice Address - City:INDIAN HARBOR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937
Practice Address - Country:US
Practice Address - Phone:321-723-7300
Practice Address - Fax:321-773-0322
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3254103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
73392Medicare ID - Type Unspecified