Provider Demographics
NPI:1720357338
Name:REESE, KATRINA E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:E
Last Name:REESE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KATRINA
Other - Middle Name:E
Other - Last Name:CLAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3021 APPLEWOOD POINT LN
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-8680
Mailing Address - Country:US
Mailing Address - Phone:704-578-5904
Mailing Address - Fax:
Practice Address - Street 1:134 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE 400
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5599
Practice Address - Country:US
Practice Address - Phone:704-664-1009
Practice Address - Fax:704-664-1029
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0075171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical