Individual provider Active NPI

Keturha Ann Reese

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1144785692
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5104 Country Side Dr
Tampa, FL 33624-2013
Phone
(813) 403-3906
NPI assigned
Feb 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Prosthetic/Orthotic Supplier 335E00000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

5104 Country Side Dr
Tampa, FL 33624-2013

Mailing address

11514 Bellamar St
Temple Terrace, FL 33637-1933
Phone (813) 403-3906

Other practice location 1

11514 Bellamar St
Temple Terrace, FL 33637-1933
Phone (813) 403-3906

Other practice location 2

11514 Bellamar St
Temple Terrace, FL 33637-1933
Phone (813) 403-3906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
K&T Raw Hair Collection Prosthetic/Orthotic Supplier Current Accepting new patients
Reese Insurance & Billing Solutions Mental Health (Including Community Mental Health Center) Current Accepting new patients

Organizations & group practices 2

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": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1144785692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11514 BELLAMAR ST",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336371933",
            "telephone_number": "813-403-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5104 COUNTRY SIDE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242013",
            "telephone_number": "813-403-3906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11514 Bellamar St",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336371933",
            "country_code": "US",
            "telephone_number": "813-403-3906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11514 Bellamar St",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336371933",
            "country_code": "US",
            "telephone_number": "813-403-3906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REESE",
        "first_name": "KETURHA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.