MEDICARE: MR. MICHAEL LEE REEVES LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	203123	TX

General Provider Information

NPI Number	:	1801382585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL LEE REEVES LMFT

Provider Business Mailing Address
First Line	:	11111 INVERNESS RD
Second Line	:
City	:	BELTON
State	:	TX
Zip	:	76513-8038
Country	:	US
Telephone Number	:	254-913-4341
Fax Number	:

Provider Business Practice Location Address
First Line	:	5100 MIDWAY DR STE 209
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-1471
Country	:	US
Telephone Number	:	254-913-4341
Fax Number	:	254-831-4596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2018
Last Update Date	:	02/13/2019

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