Provider Demographics
NPI:1689957987
Name:REESE, JAMES (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:REESE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2697 INTERNATIONAL PKWY
Mailing Address - Street 2:PARKWAY 2 - SUITE 101
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7803
Mailing Address - Country:US
Mailing Address - Phone:757-301-7129
Mailing Address - Fax:
Practice Address - Street 1:2697 INTERNATIONAL PKWY
Practice Address - Street 2:PARKWAY 2 - SUITE 101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7803
Practice Address - Country:US
Practice Address - Phone:757-301-7129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904002772106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist