Organization Active NPI

Priscilla W. Reynolds, PLC, LLC

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1144478025
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 0341 Issued in AZ
Legal business name
PRISCILLA W. REYNOLDS, PLC, LLC
Practice address
6600 N Oracle Rd
Suite 110
Tucson, AZ 85704-5676
Phone
(520) 877-8167
Fax
(520) 531-1938
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Ms. Priscilla Williamson Reynolds, LCSWNPI 1043290901
Title
Owner
Phone
(520) 877-8167

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LCSW 0341 AZ Primary

Addresses

Primary practice location

6600 N Oracle Rd
Suite 110
Tucson, AZ 85704-5676

Mailing address

6600 N Oracle Rd
Suite 110
Tucson, AZ 85704-5676
Phone (520) 877-8167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081009000017 AZ Part B Supplier - Clinic/Group Practice 6406924059 Receives reassigned benefits from 1 practitioner
Practice locations: Green Valley, AZ; Tucson, AZ

National Provider Directory

National Provider Directory

Locations

290 W Calle de las Tiendas
Green Valley, AZ 85614
Phone (520) 877-8167

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1144478025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 N ORACLE RD",
            "address_2": "SUITE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045676",
            "telephone_number": "520-877-8167",
            "fax_number": "520-531-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 N ORACLE RD",
            "address_2": "SUITE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045676",
            "telephone_number": "520-877-8167",
            "fax_number": "520-531-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISCILLA W. REYNOLDS, PLC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_middle_name": "WILLIAMSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-877-8167",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW 0341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.