Provider Demographics
NPI: | 1861848160 |
---|---|
Name: | REEVES, BABETTE DAVIS (CSWA) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | BABETTE |
Middle Name: | DAVIS |
Last Name: | REEVES |
Suffix: | |
Gender: | F |
Credentials: | CSWA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 364 SE 8TH AVE STE 301 |
Mailing Address - Street 2: | |
Mailing Address - City: | HILLSBORO |
Mailing Address - State: | OR |
Mailing Address - Zip Code: | 97123-4250 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 503-681-4233 |
Mailing Address - Fax: | 503-681-4234 |
Practice Address - Street 1: | 364 SE 8TH AVE STE 301 |
Practice Address - Street 2: | |
Practice Address - City: | HILLSBORO |
Practice Address - State: | OR |
Practice Address - Zip Code: | 97123-4250 |
Practice Address - Country: | US |
Practice Address - Phone: | 503-681-4233 |
Practice Address - Fax: | 503-681-4234 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2016-05-05 |
Last Update Date: | 2021-11-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
101YA0400X, 101YM0800X | ||
OR | L8183 | 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |