Renee Jeanne Reynolds, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904010071 Issued in VA

Practice address

3451 Conduit Rd
Colonial Heights, VA 23834-2625

Phone

(804) 524-3405

Fax

(804) 520-4342

NPI assigned

Jan 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1114435211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 GREENWOOD AVE",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342956",
            "telephone_number": "703-304-5439",
            "fax_number": "804-520-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 CONDUIT RD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342625",
            "telephone_number": "804-524-3405",
            "fax_number": "804-520-4342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Buford Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232355292",
            "country_code": "US",
            "telephone_number": "804-447-6382",
            "fax_number": "804-447-6383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "RENEE",
        "middle_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Colonial Heights, VA
• Providers in Colonial Heights, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.