Earnest Russell Reaves, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC8273 Issued in MD

Practice address

3109 Ebbtide Dr
Edgewood, MD 21040-2920

Phone

(443) 691-4982

NPI assigned

Nov 18, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Integrated Counseling Professionals LLC

  • Professional Counselor
  • Bel Air, MD
  • NPI 1245701119
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1510963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510963200000",
    "number": "1164936738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 EBBTIDE DR",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210402920",
            "telephone_number": "443-691-4982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 EBBTIDE DR",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210402920",
            "telephone_number": "443-691-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVES",
        "first_name": "EARNEST",
        "middle_name": "RUSSELL",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-18",
        "last_updated": "2017-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC8273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nina Rickey-Sharek, CRNP
• Rising Star Home Care Services

• Professional Counselor in Edgewood, MD
• Providers in Edgewood, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.