Provider Demographics
NPI:1962739565
Name:REEVE, KIRSTI JANE (LPC)
Entity type:Individual
Prefix:MS
First Name:KIRSTI
Middle Name:JANE
Last Name:REEVE
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 1:3822 ELMHURST AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-1823
Mailing Address - Country:US
Mailing Address - Phone:248-549-9125
Mailing Address - Fax:
Practice Address - Street 1:1370 N OAKLAND BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-4525
Practice Address - Country:US
Practice Address - Phone:248-666-8870
Practice Address - Fax:248-666-5023
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011612101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor