Jolynne Reynolds, PH.D., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5710 Issued in CO

Practice address

5105 W. 128TH Place
Broomfield, CO 80020-7186

Phone

(303) 875-9605

NPI assigned

May 3, 2012

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Creative Psychotherapy Institute, LLC

  • Professional Counselor
  • Broomfield, CO
  • NPI 1558712208
  NPD (past) Authorized official

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1255699765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 W. 128TH PL.",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "80020",
            "telephone_number": "303-875-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 W. 128TH PLACE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207186",
            "telephone_number": "303-875-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JOLYNNE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "5710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48800082",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.