Individual provider Active NPI

Anne Marie Reynolds, LCSW

  • Clinical Social Worker
  • Canyon Lake, TX
National Provider Identifier
1568935526
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
59207 Issued in TX
Practice address
924 Highview St
Canyon Lake, TX 78133-4274
Phone
(210) 358-9540
Fax
(210) 358-5941
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 59207 TX Primary

Addresses

Primary practice location

924 Highview St
Canyon Lake, TX 78133-4274

Mailing address

924 Highview St
Canyon Lake, TX 78133-4274
Phone (210) 358-9540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190522000722 TX Practitioner - Clinical Social Worker 9436492071 Reassigns benefits to 1 organization
I20250628000060 IN Practitioner - Clinical Social Worker 9436492071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doctor on Demand Professionals P CGroup PAC ID 9436464567, 113 clinicians

Practice addresses (Care Compare)

135 N Pennsylania St
Suite 1610
Indianapolis, IN 46204-2448
Phone (800) 997-6196

211 E 7TH St
Suite 620
Austin, TX 78701-3218
Phone (800) 997-6196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59207TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Doctor on Demand Professionals P C Single Specialty CurrentSince Oct 4, 2023 Accepting new patients
Purposeful Intentions Counseling & Consullting Current Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

275 Battery St
Ste 650
San Francisco, CA 94111
Phone 4155043838104

135 N Pennsylvania St
Ste 1610
Indianapolis, IN 46204
Phone (415) 742-8411

211 E 7th St
Ste 620
Austin, TX 78701
Phone (415) 742-8411

Interoperability endpoints

  • Direct secure messaging: annereynolds@tdh.allscriptsdirect.net
  • Direct secure messaging: anne.reynolds.1@30520.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1568935526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 HIGHVIEW ST",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781334274",
            "telephone_number": "210-358-9540",
            "fax_number": "210-358-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 HIGHVIEW ST",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781334274",
            "telephone_number": "210-358-9540",
            "fax_number": "210-358-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "59207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Lake, TX

Sources for this page

Verify at the official NPI Registry.