Healthcare Provider Details

I. General information

NPI: 1205943628
Provider Name (Legal Business Name): DONNA L REAVES LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W 38TH ST SUITE 53
AUSTIN TX
78731-6321
US

IV. Provider business mailing address

1500 W 38TH ST SUITE 53
AUSTIN TX
78731-6321
US

V. Phone/Fax

Practice location:
  • Phone: 512-377-2500
  • Fax:
Mailing address:
  • Phone: 512-377-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4620
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number936
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: