Healthcare Provider Details

I. General information

NPI: 1427270354
Provider Name (Legal Business Name): JANET OKAGBUE-REAVES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 N WASHINGTON ST SUITE 2
YPSILANTI MI
48197-2662
US

IV. Provider business mailing address

32 N WASHINGTON ST SUITE 2
YPSILANTI MI
48197-2662
US

V. Phone/Fax

Practice location:
  • Phone: 734-660-0661
  • Fax:
Mailing address:
  • Phone: 734-660-0661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6801078232
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6801078232
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801078232
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: