Individual
BRENDA MARIE REAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
825 CHICAGO AVE FL 2A, EVANSTON, IL 60202-2375
(312) 725-4088
Mailing address
155 N MICHIGAN AVE STE 760A, CHICAGO, IL 60601-7711
(312) 725-4088
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
149.021279
IL
1041C0700X
Clinical Social Worker
Primary
149.021279
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295397669
—
IL
Enumeration date
07/05/2019
Last updated
05/07/2026
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