David Jacob Reynolds, LSWAIC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC61437908 Issued in WA

Practice address

1902 2ND Ave Ste 208
Seattle, WA 98101-1186

Phone

(206) 678-4025

NPI assigned

Jun 21, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Catholic Community Services of Western Washington

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1790180214
  NPD

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1023687431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 2ND AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011155",
            "telephone_number": "206-956-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 2ND AVE STE 208",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011186",
            "telephone_number": "206-678-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "DAVID",
        "middle_name": "JACOB",
        "credential": "LSWAIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61437908",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "SC61437908",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Dolores Reyna Johnson, SUDPT
• Evan Adrian Reyna
• Ashley Reynolds, DNP, ARNP, FNP-BC
• Barbara Jean Reynolds
• Carsyn Reynolds
• Hannah Elizabeth Reynolds, CRNA
• Jeffrey Reynolds
• Martha Lee Reynolds, M.S.W., L.I.C.S.W.
• Melanie Reynolds
• Nicholas Martin Reynolds, M.ED, BCBA

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.