Provider Demographics
NPI:1932971785
Name:REEVES, SAMIA M (M ED, NCC)
Entity type:Individual
Prefix:MS
First Name:SAMIA
Middle Name:M
Last Name:REEVES
Suffix:
Gender:F
Credentials:M ED, NCC
Other - Prefix:
Other - First Name:SAMIA
Other - Middle Name:
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:500 N 21ST ST APT 414
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-4241
Mailing Address - Country:US
Mailing Address - Phone:267-304-9461
Mailing Address - Fax:
Practice Address - Street 1:1445 CITY LINE AVE
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3831
Practice Address - Country:US
Practice Address - Phone:215-519-2531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1494716101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty