Organization Active NPI

Reese Counseling LLC

  • Mental Health Counselor
  • Victorville, CA
National Provider Identifier
1538819867
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
REESE COUNSELING LLC
Practice address
15437 Anacapa Rd
Victorville, CA 92392-2458
Phone
(760) 220-7120
Fax
(208) 963-3040
NPI assigned
Mar 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Authorized official

Name
Jacqueline Reese, LMFTNPI 1770765430
Title
Psychotherapist
Phone
(760) 220-7120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

15437 Anacapa Rd
Victorville, CA 92392-2458

Mailing address

1730 N Sevenoaks Way
Eagle, ID 83616-6619
Phone (760) 220-7120

Other practice location 1

1730 N Sevenoaks Way
Eagle, ID 83616-6619
Phone (760) 220-7120

Other identifiers 1

IdentifierTypeStateIssuer
51043OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251205002233 CA Part B Supplier - Clinic/Group Practice 3779076880 Receives reassigned benefits from 1 practitioner
Practice locations: Victorville, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1538819867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 N SEVENOAKS WAY",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166619",
            "telephone_number": "760-220-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15437 ANACAPA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922458",
            "telephone_number": "760-220-7120",
            "fax_number": "208-963-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 N Sevenoaks Way",
            "address_purpose": "LOCATION",
            "city": "Eagle",
            "state": "ID",
            "postal_code": "836166619",
            "country_code": "US",
            "telephone_number": "760-220-7120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REESE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "760-220-7120",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "51043",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.