Anna Marie Reavis, LCMHC-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A17855 Issued in NC

Practice address

163 Stratford CT Ste 170
Winston Salem, NC 27103-1833

Phone

(336) 831-4051

NPI assigned

Aug 16, 2022

Sex

Female

Sole proprietor

Yes

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": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1194443200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 W FRIENDLY AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031825",
            "telephone_number": "336-244-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 STRATFORD CT STE 170",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031833",
            "telephone_number": "336-831-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3859 Battleground Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274109802",
            "country_code": "US",
            "telephone_number": "336-370-5240",
            "fax_number": "704-237-4240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REAVIS",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "LCMHC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2023-03-17",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A17855",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A17855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Reams, NNP
• Alexandra Reardon
• Michael A. Reardon, M.D.
• Chelsea Michele Reasor, NCC, LPCA
• Margurite Reaves, LCSWA
• Jerry Ray Reavis, DC
• Rebecca S. Valla, MD
• Gerald Rebo, PHARMD, BCPS, CCP
• Kristin Anne Rebo, PHARMD, CPP
• Jessica Marie Rebollar, PA-C

• Mental Health Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.