Jadi Jo Reynolds, LAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Keller, WA
NPI 1144940917 · NPPES record last updated Aug 31, 2022
Key facts
- NPI
- 1144940917
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 50568 (MT)
- Practice address
- 11614 S Highway 21
Keller, WA 99140-9537 - Phone
- (509) 634-2050
- NPI assigned
- Aug 31, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50568 | MT | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Confederated Tribes of the Colville Reservation | Current |
Accepting new patients | |
| Confederated Tribes of the Colville Reservation | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 50568 | MT | Yes |
Addresses
Primary practice location
11614 S Highway 21
Keller, WA 99140-9537
Mailing address
PO Box 150
Nespelem, WA 99155-0150
Phone (509) 634-2610
Other providers in Keller, WA
- Colville Nation Community Health Centers
- Confederated Tribes of the Colville Reservation
- Confederated Tribes of the Colville Reservation
- Sheri Gray
- Keller School District
All providers in Keller, WA · Addiction (Substance Use Disorder) Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.