Jennifer Reynolds, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904013138 Issued in VA

Practice address

6063 Arlington Blvd
Falls Church, VA 22044-2721

Phone

(703) 533-3930

NPI assigned

Jul 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2022 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1518575463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6063 ARLINGTON BLVD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220442721",
            "telephone_number": "240-479-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6063 ARLINGTON BLVD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220442721",
            "telephone_number": "703-533-3930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8120 Woodmont Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208142743",
            "country_code": "US",
            "telephone_number": "240-479-9464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JENNIFER",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2022-09-22",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19120",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200001347",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013138",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "19120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EVOLV",
            "affiliation": "N",
            "address_1": "16220 Frederick Rd Ste 502",
            "city": "Gaithersburg",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208774022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Retnuh Health LLC
• Kristina K Reyes
• Manuel Alexander Reyes, DO
• Mary Jane Reyes, MD
• Natalia Reynaga
• John Reynolds, ATC
• Leia Ellen Reynolds, M.S., ED.S.
• Megan Elise Reynolds, PA-C
• Jenny Kim Rhee, NP
• Tracy Rhee

• Clinical Social Worker in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.

Verify at the official NPI Registry.