Healthcare Provider Details

I. General information

NPI: 1255200432
Provider Name (Legal Business Name): COURTNEY NICOLE REEVES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 PARAGON PL STE 237
RICHMOND VA
23230-1651
US

IV. Provider business mailing address

6800 PARAGON PL STE 237
RICHMOND VA
23230-1651
US

V. Phone/Fax

Practice location:
  • Phone: 804-562-9997
  • Fax:
Mailing address:
  • Phone: 804-562-9997
  • Fax: 804-918-8248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904019549
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: