Nicole Marie Reynolds

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851121686 Issued in MI

Practice address

6063 Eastwood Dr
Burtchville, MI 48059-2536

Phone

(810) 841-4108

NPI assigned

Jul 10, 2024

Last updated

May 26, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1134966724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6063 EASTWOOD DR",
            "city": "BURTCHVILLE",
            "state": "MI",
            "postal_code": "480592536",
            "telephone_number": "810-841-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6063 EASTWOOD DR",
            "city": "BURTCHVILLE",
            "state": "MI",
            "postal_code": "480592536",
            "telephone_number": "810-841-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851121686",
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakin Marie Hering
• Benjamin George Martin Jr.
• Karin E Mayer, ACC
• Sean Alexander Nemorin
• Jacob Prevost
• Kurt Allen Richardson, M.D.
• St. Joseph Mercy Hospital
• Judith Troy
• Danielle Wickings

• Clinical Social Worker in Burtchville, MI
• Providers in Burtchville, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; 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.