Provider Demographics
NPI:1932918943
Name:MCKELVEY, REESHEMAH J
Entity type:Individual
Prefix:
First Name:REESHEMAH
Middle Name:J
Last Name:MCKELVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 PALMETTO BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-3015
Mailing Address - Country:US
Mailing Address - Phone:843-437-6788
Mailing Address - Fax:
Practice Address - Street 1:1253 DICKSON AVE STE 104
Practice Address - Street 2:
Practice Address - City:HANAHAN
Practice Address - State:SC
Practice Address - Zip Code:29410-2853
Practice Address - Country:US
Practice Address - Phone:843-437-6788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17386104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker