Nichole Brandy Ann Reynolds

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

701 S 9TH St
Canon City, CO 81212-4911

Phone

(719) 275-2351

NPI assigned

Mar 14, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nichole Brandy Ann Lister Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1215737622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 NORTH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128662",
            "telephone_number": "719-429-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124911",
            "telephone_number": "719-275-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "NICHOLE",
        "middle_name": "BRANDY ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "LISTER",
            "middle_name": "BRANDY ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rehab for All LLC
• Rehab for All LLC
• Sheila Repka, NP
• James Fred Reppert, M.D.
• Restorative Counseling Services LLC
• William Reynolds
• Richard Rivera MDPC
• Erik Herbert Rieger, M.D.
• Jasmine Renee Riley
• Darvin Ritchie, MD

• Clinical Social Worker in Canon City, CO
• Providers in Canon City, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.