Provider Demographics
NPI:1063761328
Name:REEVES, HOLLY ANNE (LPC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANNE
Last Name:REEVES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1073
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39566-1073
Mailing Address - Country:US
Mailing Address - Phone:228-875-6113
Mailing Address - Fax:228-875-9065
Practice Address - Street 1:5009 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39567-1832
Practice Address - Country:US
Practice Address - Phone:228-875-6113
Practice Address - Fax:228-875-9065
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1695101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional