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General NPI Number Information
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NPI Number | 1528397726
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Entity Type | Individual
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Provider Name | SHELLY REAVES LPC, LADAC, MAC, SAP
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Gender | Female
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 1730 SE MOBERLY LN STE 5
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City | BENTONVILLE
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State | AR
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Zip | 72712-7643
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Country | US
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Telephone | 479-422-4657
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Fax |
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Provider Business Mailing Address
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Address Line | 1730 SE MOBERLY LN STE 5
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City | BENTONVILLE
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State | AR
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Zip | 72712-7643
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Country | US
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Telephone | 479-422-4657
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P1211111
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 356L
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License Number State | AR
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