Provider Demographics
NPI:1558901942
Name:REEVES, ADELINE (LPC)
Entity Type:Individual
Prefix:
First Name:ADELINE
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ADELINE
Other - Middle Name:
Other - Last Name:ZEMCIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1530 BECKWITH VIEW AVE NE APT 13
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-5882
Mailing Address - Country:US
Mailing Address - Phone:989-763-0797
Mailing Address - Fax:
Practice Address - Street 1:1410 84TH ST SW
Practice Address - Street 2:
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-9344
Practice Address - Country:US
Practice Address - Phone:616-222-0631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017638101YP2500X
MI6401222395101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional