Richard D Reynolds, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2005019482 Issued in MO

Practice address

143 Mill Street
Raymondville, MO 65555

Phone

(417) 457-6548

NPI assigned

May 17, 2010

Last updated

Sep 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • Professional Counselor
  • Kansas City, MO
  • NPI 1861143679
  Medicare reassignment NPD
• Katie Community Health Center, LLC

  • Clinical Social Worker
  • Raymondville, MO
  • NPI 1295053957
  NPD (past)

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1518285402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 W ELM ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061529",
            "telephone_number": "417-429-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 MILL STREET",
            "city": "RAYMONDVILLE",
            "state": "MO",
            "postal_code": "65555",
            "telephone_number": "417-457-6548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "RICHARD",
        "middle_name": "D",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2005019482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Community Health Center, LLC

• Clinical Social Worker in Raymondville, MO
• Providers in Raymondville, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.