Individual provider Active NPI

Kayla Ann Reeve, LMFTA

  • Marriage & Family Therapist
  • Charlotte, NC
National Provider Identifier
1093464240
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
12381A Issued in NC
Practice address
5200 Park Rd Ste 101
Charlotte, NC 28209-3669
Phone
(704) 272-3905
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 12381A NC Primary

Addresses

Primary practice location

5200 Park Rd Ste 101
Charlotte, NC 28209-3669

Mailing address

3928 Lake Breeze Dr
Sherrills Ford, NC 28673-9417
Phone (818) 633-8375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 29, 2024 through Apr 29, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12381ANCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Collaborative PLLC Current Accepting new patients

Locations

1235 East Blvd
Ste E
Charlotte, NC 28203
Phone (866) 736-6408

233 S Sharon Amity Rd
Ste 202
Charlotte, NC 28211

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1093464240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3928 LAKE BREEZE DR",
            "city": "SHERRILLS FORD",
            "state": "NC",
            "postal_code": "286739417",
            "telephone_number": "818-633-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 PARK RD STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093669",
            "telephone_number": "704-272-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVE",
        "first_name": "KAYLA",
        "middle_name": "ANN",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12381A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.