Provider Demographics
NPI:1144698457
Name:REEVE, SHAUN (ACHMC)
Entity type:Individual
Prefix:MR
First Name:SHAUN
Middle Name:
Last Name:REEVE
Suffix:
Gender:M
Credentials:ACHMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1576 S 500 W STE 202
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84010-7433
Mailing Address - Country:US
Mailing Address - Phone:801-406-9002
Mailing Address - Fax:801-972-2709
Practice Address - Street 1:1576 S 500 W STE 202
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-7433
Practice Address - Country:US
Practice Address - Phone:801-406-9002
Practice Address - Fax:801-294-5286
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
UT10823232-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor