Provider Demographics
NPI:1255859146
Name:LAUREN REEVES COUNSELING PA
Entity type:Organization
Organization Name:LAUREN REEVES COUNSELING PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-317-2619
Mailing Address - Street 1:5447 N MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:JAY
Mailing Address - State:FL
Mailing Address - Zip Code:32565-1213
Mailing Address - Country:US
Mailing Address - Phone:352-317-2619
Mailing Address - Fax:850-204-1649
Practice Address - Street 1:5447 N MURPHY RD
Practice Address - Street 2:
Practice Address - City:JAY
Practice Address - State:FL
Practice Address - Zip Code:32565-1213
Practice Address - Country:US
Practice Address - Phone:352-317-2619
Practice Address - Fax:850-204-1649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJP4GDOtherFL BLUE