Provider Demographics
NPI:1871264945
Name:REECE, CORYNTHIA LYNNETTE (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:CORYNTHIA
Middle Name:LYNNETTE
Last Name:REECE
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 KINSEY DR APT 1513
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3031
Mailing Address - Country:US
Mailing Address - Phone:903-649-2012
Mailing Address - Fax:
Practice Address - Street 1:4901 KINSEY DR APT 1513
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3031
Practice Address - Country:US
Practice Address - Phone:903-649-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78971101YM0800X, 101YP2500X
TX15213101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)