Samantha Reynolds

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4110 N Water Tower PL
Mount Vernon, IL 62864-6295

Phone

(618) 242-2066

NPI assigned

Jan 9, 2025

Sex

Female

Sole proprietor

No

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)

Not enrolled

Practice roles

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.

• One Hope United

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Vernon, IL
  • NPI 1841539640
  NPD (past)

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1114737335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 W LAIR ST",
            "city": "VERNON",
            "state": "IL",
            "postal_code": "628921200",
            "telephone_number": "618-292-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 N WATER TOWER PL",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646295",
            "telephone_number": "618-242-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Renee Reich
• Renal Life Link Inc
• Rend Emergency Physicians
• Kathleen S Renner, D.M.D
• Resilient Roots Therapy PLLC
• Lynn Rheinecker, PHARM.D., R.PH.
• Natasha Carol Rhodes, AGNP-C
• Amy Lynn Richards
• Lisa Riley, COTA/L
• Julie Ann Cammon Rinehart, CNM, WHNP-BC

• Mental Health Counselor in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.