Provider Demographics
NPI:1063291656
Name:REEVES, ALLISON K
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:K
Last Name:REEVES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:402 WHITTINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-8325
Mailing Address - Country:US
Mailing Address - Phone:601-291-8884
Mailing Address - Fax:
Practice Address - Street 1:141 TOWNSHIP AVE
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-8698
Practice Address - Country:US
Practice Address - Phone:601-202-3543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3244101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional