Healthcare Provider Details

I. General information

NPI: 1518899574
Provider Name (Legal Business Name): REESE RICHMOND LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5418 N EAGLE RD STE 160
BOISE ID
83713-0100
US

IV. Provider business mailing address

1210 S ABBS ST
BOISE ID
83705-2435
US

V. Phone/Fax

Practice location:
  • Phone: 512-489-9723
  • Fax:
Mailing address:
  • Phone: 916-267-8791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number8481414
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: