Active NPI
Susan Reynolds
- Marriage & Family Therapist
- Rochester, NY
National Provider Identifier
1467060012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 000981
- Practice address
- 3380 Monroe Ave Ste 117
Rochester, NY 14618-4726 - Phone
- (585) 704-8666
- NPI assigned
- Jul 20, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 000981 | NY | Primary |
Addresses
Primary practice location
3380 Monroe Ave Ste 117
Rochester, NY 14618-4726
Mailing address
3380 Monroe Ave Ste 117
Rochester, NY 14618-4726
Phone (585) 704-8666
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 |
|---|---|---|---|
| 000981 | NY | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595203200000",
"number": "1467060012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3380 MONROE AVE STE 117",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146184726",
"telephone_number": "585-704-8666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3380 MONROE AVE STE 117",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146184726",
"telephone_number": "585-704-8666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-20",
"last_updated": "2020-07-20",
"certification_date": "2020-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NY",
"license": "000981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.