MEDICARE: MR. SEAN BRANDON REEVES 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	1041C0700X	Clinical Social Worker	4193	LA

General Provider Information

NPI Number	:	1245513928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEAN BRANDON REEVES LCSW

Provider Business Mailing Address
First Line	:	8762 QUARTERS LAKE RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-7300
Country	:	US
Telephone Number	:	225-286-3307
Fax Number	:

Provider Business Practice Location Address
First Line	:	10935 PERKINS RD STE D
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-3005
Country	:	US
Telephone Number	:	225-267-7431
Fax Number	:

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

Provider Enumeration Date	:	09/20/2011
Last Update Date	:	03/06/2026

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