Individual provider Active NPI

Breyonna Elizabeth Reese

  • Mental Health Counselor
  • Norcross, GA
National Provider Identifier
1609435924
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3040 Holcomb Bridge Rd Ste J2
Norcross, GA 30071-1357
Phone
(770) 696-9231
NPI assigned
Jun 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3040 Holcomb Bridge Rd Ste J2
Norcross, GA 30071-1357

Mailing address

639 Garden Walk Blvd Apt 1323
Atlanta, GA 30349-6640
Phone (678) 791-9526

Other practice location 1

3040 Holcomb Bridge Rd Ste J2
Norcross, GA 30071-1357

Other practice location 2

3040 Holcomb Bridge Rd
Norcross, GA 30071-1377

Other practice location 3

3040 Holcomb Bridge Rd
Norcross, GA 30071-1377

Other practice location 4

3040 Holcomb Bridge Rd Ste J2
Norcross, GA 30071-1357

Other practice location 5

3040 Holcomb Bridge Rd Ste J2
Norcross, GA 30071-1357

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

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1609435924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 GARDEN WALK BLVD APT 1323",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303496640",
            "telephone_number": "678-791-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 HOLCOMB BRIDGE RD STE J2",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711357",
            "telephone_number": "770-696-9231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3040 Holcomb Bridge Rd Ste J2",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300711357",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3040 Holcomb Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300711377",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3040 Holcomb Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300711377",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3040 Holcomb Bridge Rd Ste J2",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300711357",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3040 Holcomb Bridge Rd Ste J2",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300711357",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REESE",
        "first_name": "BREYONNA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.