Active NPI
Charles Norman Reynolds, MSW
- Social Worker
- Dunbar, WV
National Provider Identifier
1285804377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- AP00451774
- Practice address
- 1020 Grosscup Ave
Dunbar, WV 25064-3128 - Phone
- (304) 766-7336
- Fax
- (304) 525-1073
- NPI assigned
- Mar 5, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | AP00451774 | WV | Primary |
Addresses
Primary practice location
1020 Grosscup Ave
Dunbar, WV 25064-3128
Mailing address
1020 Grosscup Ave
Dunbar, WV 25064-3128
Phone (304) 766-7336
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005355002 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP00451774 | WV | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prestera Center for Mental Health Services Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Huntington, WV
- NPI 1992394860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1285804377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 GROSSCUP AVE",
"city": "DUNBAR",
"state": "WV",
"postal_code": "250643128",
"telephone_number": "304-766-7336",
"fax_number": "304-525-1073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 GROSSCUP AVE",
"city": "DUNBAR",
"state": "WV",
"postal_code": "250643128",
"telephone_number": "304-766-7336",
"fax_number": "304-525-1073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "CHARLES",
"middle_name": "NORMAN",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-05",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WV",
"license": "AP00451774",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0005355002",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dunbar, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.