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General NPI Number Information
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NPI Number | 1700457488
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Entity Type | Individual
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Provider Name | SOPHIE K REAVES LCMHC
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Gender | Female
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Dates
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Enumeration Date | 07/05/2021
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Last Update Date | 02/04/2024
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Provider Practice Location Address
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Address Line | 3305 16TH AVE SE STE 207A
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City | CONOVER
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State | NC
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Zip | 28613-9213
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Country | US
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Telephone | 828-380-5839
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Fax | 704-973-7865
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Provider Business Mailing Address
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Address Line | 615 RIVER HIGHWAY PMB 1072
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City | MOORESVILLE
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State | NC
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Zip | 28117-9286
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Country | US
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Telephone | 828-838-9322
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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 | A16737
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License Number State | NC
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