Provider Demographics
NPI:1619476074
Name:REAVES, DENISE MARIE (LCSW, CAADC)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MARIE
Last Name:REAVES
Suffix:
Gender:F
Credentials:LCSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 CARRIE WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-2413
Mailing Address - Country:US
Mailing Address - Phone:304-886-9720
Mailing Address - Fax:
Practice Address - Street 1:423 W CORK ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3812
Practice Address - Country:US
Practice Address - Phone:540-535-1111
Practice Address - Fax:540-450-1205
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA090400970001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical