Individual provider Active NPI

Julianne L Reynolds, LPC

  • Professional Counselor
  • Saint Louis, MO
National Provider Identifier
1114518339
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2020043275 Issued in MO
Practice address
11628 Old Ballas Rd Ste 222
Saint Louis, MO 63141-7030
Phone
(636) 368-5745
NPI assigned
Jan 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2020043275 MO Primary

Addresses

Primary practice location

11628 Old Ballas Rd Ste 222
Saint Louis, MO 63141-7030

Mailing address

11628 Old Ballas Rd Ste 222
Saint Louis, MO 63141-7030
Phone (636) 368-5745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240613003937 MO Practitioner - Mental Health Counselor 9739622184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11628 Old Ballas Rd
Saint Louis, MO 63141-7030
Phone (636) 368-5745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020043275MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Julianne Reynolds LLC Professional CurrentSince Mar 26, 2024 Accepting new patients

Locations

11628 Old Ballas Rd
Saint Louis, MO 63141
Phone (314) 579-9664

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1611964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1114518339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11628 OLD BALLAS RD STE 222",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417030",
            "telephone_number": "636-368-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11628 OLD BALLAS RD STE 222",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417030",
            "telephone_number": "636-368-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JULIANNE",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-30",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2020043275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.