Michelle M. Reynolds, PH.D., LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002786 Issued in CT

Legal business name

MICHELLE M. REYNOLDS, PH.D., LLC

Practice address

33 Pratt St
Glastonbury, CT 06033-1014

Phone

(203) 376-8284

Fax

(860) 781-6464

NPI assigned

Feb 29, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Michelle M Reynolds, PH.D.

Title

Psychologist

Phone

(203) 376-8284

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1275993636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 165",
            "city": "DURHAM",
            "state": "CT",
            "postal_code": "064220165",
            "telephone_number": "203-376-8284",
            "fax_number": "860-781-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 PRATT ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331014",
            "telephone_number": "203-376-8284",
            "fax_number": "860-781-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE M. REYNOLDS, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-29",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "203-376-8284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.