Willow Bryn Reynolds, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW43175 Issued in ID

Practice address

8 6TH St N
Nampa, ID 83687-5015

Phone

(208) 467-7423

NPI assigned

Mar 23, 2018

Sex

Female

Sole proprietor

No

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

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Medical Directors of Idaho PLLC

  • Internal Medicine Physician
  • Nampa, ID
  • NPI 1710392410
  Medicare reassignment NPD

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1255835195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 N SHERWOOD DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511859",
            "telephone_number": "208-477-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 6TH ST N",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875015",
            "telephone_number": "208-467-7423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1031 W Sanetta St",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836515047",
            "country_code": "US",
            "telephone_number": "208-466-7443",
            "fax_number": "208-466-5058",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1603 12th Ave Rd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836867712",
            "country_code": "US",
            "telephone_number": "208-442-0096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "WILLOW",
        "middle_name": "BRYN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW37316",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW43175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resilient Transport LLC
• Revitalize Consulting Group, Inc.
• Jorge Domingo Reyes, MS
• John Reyna, LCPC
• Kathryn C Reynolds, PHARMD
• Rhythm & Grace Counseling
• Ricardo Ramirezs Counseling PLLC
• Ariel Melissa Rice
• Megan Rice, LPC
• Richard D Gallagher DC

• Clinical Social Worker in Nampa, ID
• Providers in Nampa, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.