MEDICARE: JAMEE REESE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	0904004941	VA

General Provider Information

NPI Number	:	1013033810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMEE REESE LCSW

Provider Business Mailing Address
First Line	:	2308 CAMPOSTELLA RD
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23324-3939
Country	:	US
Telephone Number	:	757-469-2525
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 TIDEWATER DR
Second Line	:	STE. A
City	:	NORFOLK
State	:	VA
Zip	:	23504-3300
Country	:	US
Telephone Number	:	757-533-9242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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