Reese, Matthew Bradley

Reese, Matthew Bradley is an individual health care provider with primary practice located at 1596 Highway 33 S , New Tazewell TN 37825-7104. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Reese, Matthew Bradley can be contacted via phone (423) 626-2965.

Contact Information

Primary practice address
1596 Highway 33 S New Tazewell TN 37825-7104
Fax: (423) 626-2968
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LSW923 Tennessee

Profile Details

NPI number 1790783918
LBN Legal business name Reese, Matthew Bradley
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Nov 30th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790783918 NPPES
Tennessee MEDICAID 3924910

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