Healthcare Provider Details

I. General information

NPI: 1073296588
Provider Name (Legal Business Name): MATTHEW BRIAN REESE LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5635 PEACHTREE PKWY STE 180
PEACHTREE CORNERS GA
30092-2823
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 470-938-6670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC014814
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: