Provider Demographics
NPI:1477845196
Name:REESE, ASHONDA LYNETTE (LCSW, PIP)
Entity Type:Individual
Prefix:
First Name:ASHONDA
Middle Name:LYNETTE
Last Name:REESE
Suffix:
Gender:F
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 WOODBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SEMMES
Mailing Address - State:AL
Mailing Address - Zip Code:36575-7465
Mailing Address - Country:US
Mailing Address - Phone:251-533-8503
Mailing Address - Fax:
Practice Address - Street 1:1825 WOODBROOK DR
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-7465
Practice Address - Country:US
Practice Address - Phone:251-533-8503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2197C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker