Provider Demographics
NPI:1710852892
Name:REAVES, JESSICA (MED, NCC, ALC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:REAVES
Suffix:
Gender:F
Credentials:MED, NCC, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E VETERANS BLVD APT 15B
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-6954
Mailing Address - Country:US
Mailing Address - Phone:334-521-8725
Mailing Address - Fax:
Practice Address - Street 1:166 N GAY ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4800
Practice Address - Country:US
Practice Address - Phone:334-329-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health