Individual provider Active NPI

Jennifer E Reynolds, LCSW

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1124424650
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9923325 Issued in CO
Practice address
1776 S Jackson St
Suite 700
Denver, CO 80210-3801
Phone
(303) 204-9406
Fax
(303) 640-3199
NPI assigned
Nov 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9923325 CO Primary

Addresses

Primary practice location

1776 S Jackson St
Suite 700
Denver, CO 80210-3801

Mailing address

1201 Mulberry LN
Highlands Ranch, CO 80129-6265
Phone (303) 204-9406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9923325COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Graceful Guidance Care Management PastSince Jan 19, 2017 Accepting new patients

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": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1124424650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MULBERRY LN",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801296265",
            "telephone_number": "303-204-9406",
            "fax_number": "303-640-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 S JACKSON ST",
            "address_2": "SUITE 700",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103801",
            "telephone_number": "303-204-9406",
            "fax_number": "303-640-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-11",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "9923325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.