Stacey L Reynolds

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5931 Issued in OK

Practice address

400 S Broadway Ste 15
Edmond, OK 73034-3848

Phone

(405) 562-4891

NPI assigned

Jan 31, 2014

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482
  NPD (past)

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

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1134542889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 SW 44TH ST STE 500",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093615",
            "telephone_number": "405-605-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BROADWAY STE 15",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343848",
            "telephone_number": "405-562-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "STACEY",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-31",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "5931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200522860A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Megan Reynolds
• Jonathan Seth Reynolds, LMFT, LCMFT
• Kelly C Reynolds
• Kylie Reynolds
• Ryan Kednall Reynolds
• RH and Co Counseling, LLC
• Rhama Counseling
• Scott Rhinehart
• Melinda Rhoades, LPC
• Aaliyah Harmony Rhodes

• Professional Counselor in Edmond, OK
• Providers in Edmond, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.