Individual provider Active NPI

Olivia Rose Reyes, LGPC

  • Mental Health Counselor
  • Frederick, MD
National Provider Identifier
1588556575
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LGP14063 Issued in MD
Practice address
7420 Hayward Rd Ste 104
Frederick, MD 21702-2510
Phone
(240) 575-9480
NPI assigned
Jul 16, 2025
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP14063 MD Primary

Addresses

Primary practice location

7420 Hayward Rd Ste 104
Frederick, MD 21702-2510

Mailing address

12124 Skip Jack Dr
Germantown, MD 20874-2567
Phone (240) 477-2109

Other practice location 1

12124 Skip Jack Dr
Germantown, MD 20874-2567
Phone (240) 477-2109

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

LicenseStateTypeSpecialty
LGP14063MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1588556575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12124 SKIP JACK DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742567",
            "telephone_number": "240-477-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 HAYWARD RD STE 104",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022510",
            "telephone_number": "240-575-9480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12124 Skip Jack Dr",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208742567",
            "country_code": "US",
            "telephone_number": "240-477-2109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "OLIVIA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "LGPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP14063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.