Provider Demographics
NPI:1821986894
Name:REEVES, MICAH MAGDALYN (RBT)
Entity type:Individual
Prefix:
First Name:MICAH
Middle Name:MAGDALYN
Last Name:REEVES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:MICAH
Other - Middle Name:MAGDALYN
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:623 WEAVER ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-1661
Mailing Address - Country:US
Mailing Address - Phone:731-798-6732
Mailing Address - Fax:
Practice Address - Street 1:759 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-1738
Practice Address - Country:US
Practice Address - Phone:731-968-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-24-340621106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician