Adam Lloyd Reynolds, LMSW, CASAC
Individual provider Active NPI Clinical Social Worker · Jackson HTS, NY
NPI 1003255050 · NPPES record last updated Jun 21, 2013
Key facts
- NPI
- 1003255050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 082465 (NY)
- Practice address
- 3727 86TH St Apt 5R
Jackson HTS, NY 11372-7416 - Phone
- (917) 216-0614
- NPI assigned
- Jun 21, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23622 | NY | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 23622 | NY | |
| Clinical Social Worker | 1041C0700X | 082465 | NY | Yes |
Addresses
Primary practice location
3727 86TH St Apt 5R
Jackson HTS, NY 11372-7416
Mailing address
3727 86TH St Apt 5R
Jackson HTS, NY 11372-7416
Phone (917) 216-0614
Other providers in Jackson HTS, NY
- Opus Therapy LCSW, PC
- Eduardo Jorge Pallanza
- Kirpal Candy Panilag
- Susan Perez
- Queens County Neuropsychiatric Institute Inc.
- Elpidio S Rosario
- Maria Claudia Torres
- Unit of Internal Medical Care PLLC
- Cesar R Vera
- Sudha Vijaykumar
All providers in Jackson HTS, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.