MEDICARE: LATONYA T REESE LICDC, LPC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LICDC.162254	OH
2	101YM0800X	Mental Health Counselor	E.2606036	OH

General Provider Information

NPI Number	:	1629561105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATONYA T REESE LICDC, LPC

Provider Business Mailing Address
First Line	:	11307 LINCOLNSHIRE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-2338
Country	:	US
Telephone Number	:	513-344-4089
Fax Number	:

Provider Business Practice Location Address
First Line	:	11307 LINCOLNSHIRE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-2338
Country	:	US
Telephone Number	:	513-344-4089
Fax Number	:

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

Provider Enumeration Date	:	06/11/2018
Last Update Date	:	01/25/2026

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