Healthcare Provider Details

I. General information

NPI: 1659147635
Provider Name (Legal Business Name): CULTIVATE PSYCHIATRY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4034 N HAMPTON DR
POWELL OH
43065-8445
US

IV. Provider business mailing address

4034 N HAMPTON DR
POWELL OH
43065-8445
US

V. Phone/Fax

Practice location:
  • Phone: 614-588-8131
  • Fax: 330-776-5557
Mailing address:
  • Phone: 740-901-1174
  • Fax: 330-776-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KINSEY KAY REEVES
Title or Position: OWNER
Credential: NP
Phone: 419-357-3674