Active NPI
John Brently Reynolds II
- Mental Health Counselor
- Cambridge, MA
National Provider Identifier
1447557442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 14 Cottage Park Ave
Cambridge, MA 02140-1606 - Phone
- (405) 921-2180
- NPI assigned
- Feb 28, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
14 Cottage Park Ave
Cambridge, MA 02140-1606
Mailing address
14 Cottage Park Ave
Cambridge, MA 02140-1606
Phone (405) 921-2180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 25, 2025 through Sep 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298851200000",
"number": "1447557442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 COTTAGE PARK AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021401606",
"telephone_number": "405-921-2180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 COTTAGE PARK AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021401606",
"telephone_number": "405-921-2180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "JOHN",
"middle_name": "BRENTLY",
"name_suffix": "II",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-28",
"last_updated": "2011-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.