Healthcare Provider Details

I. General information

NPI: 1740910231
Provider Name (Legal Business Name): REECE HASSELL BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 SAND PEBBLE DR STE A
JACKSON TN
38305-7591
US

IV. Provider business mailing address

2795 INDEPENDENCE LOOP
LEXINGTON TN
38351-6085
US

V. Phone/Fax

Practice location:
  • Phone: 855-444-5664
  • Fax:
Mailing address:
  • Phone: 502-633-1007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2067
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: