Mary Reeves, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-67169 Issued in TX

Practice address

2417 Presidio Vista Dr
Fort Worth, TX 76177-8277

Phone

(682) 316-9008

NPI assigned

Jan 18, 2022

Reactivated

Sep 12, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695513600000",
    "number": "1144972498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 PRESIDIO VISTA DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761778277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 PRESIDIO VISTA DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761778277",
            "telephone_number": "682-316-9008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 W Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044351",
            "country_code": "US",
            "telephone_number": "817-601-9736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEVES",
        "first_name": "MARY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2023-09-24",
        "certification_date": "2023-09-24",
        "deactivation_date": "2023-08-17",
        "reactivation_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "RBT-17-38177",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-23-67169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David L Reeve, M.D.
• Nancy W Reeve, RN, WHCNP
• Andrea Grace Reeves
• Cassandra Reeves
• Emilie A Reeves, M.D.
• Rachel Reeves, MABC
• Robert Timothy Reeves, D.D.S.
• Sara Salo Reeves
• Tallon Nicole Reeves, PT, DPT
• Tausha Reeves, PHARM. D.

• Behavior Analyst in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2023; 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.