Individual provider Active NPI

Wende Danford Reynolds, LPC

  • Professional Counselor
  • Charleston, SC
National Provider Identifier
1609135193
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3497 Issued in SC
Practice address
1171 Southgate Dr
Charleston, SC 29407-4209
Phone
(843) 830-1002
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3497 SC Primary

Addresses

Primary practice location

1171 Southgate Dr
Charleston, SC 29407-4209

Mailing address

2122 Chancellory LN
Charleston, SC 29414-6248
Phone (843) 830-1002

Other names 1

  • Wende Danford Tolbert Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20240222001555 SC Practitioner - Mental Health Counselor 9234573817 Practice locations: Charleston, SC

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1171 Southgate Dr
Charleston, SC 29407-4209
Phone (843) 830-1002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
3497SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dream Partners Professional CurrentSince Aug 1, 2024 Accepting new patients

Locations

1171 Southgate Dr
Charleston, SC 29407
Phone (803) 525-4085

Organizations & group practices 1

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": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1609135193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 CHANCELLORY LN",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146248",
            "telephone_number": "843-830-1002",
            "fax_number": "888-975-5943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 SOUTHGATE DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074209",
            "telephone_number": "843-830-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "WENDE",
        "middle_name": "DANFORD",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "3497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDE",
            "last_name": "TOLBERT",
            "middle_name": "DANFORD",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.