Provider Demographics
NPI:1780600965
Name:REEVES, CATHY CLANTON (PHD)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:CLANTON
Last Name:REEVES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 ASHLEY CIR STE 3
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-5821
Mailing Address - Country:US
Mailing Address - Phone:270-842-0029
Mailing Address - Fax:270-782-8875
Practice Address - Street 1:1212 ASHLEY CIR STE 3
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-5821
Practice Address - Country:US
Practice Address - Phone:270-842-0029
Practice Address - Fax:270-782-8875
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2014-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-752103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist