Individual provider Active NPI

Christina Marie Reynolds, M.A.

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1649419920
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH 7229 Issued in FL
Practice address
3900 Broadway
Suite B-1
Fort Myers, FL 33901-8193
Phone
(239) 939-2808
Fax
(239) 939-4794
NPI assigned
Feb 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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 IMH 7229 FL Primary

Addresses

Primary practice location

3900 Broadway
Suite B-1
Fort Myers, FL 33901-8193

Mailing address

3900 Broadway
Suite B-1
Fort Myers, FL 33901-8193
Phone (239) 939-2808

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
IMH 7229FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Advocacy Center of SW FL, Inc Mental Health Past Accepting new patients
Children'S Advocacy Center of SWFL Past Accepting new patients

Organizations & group practices 2

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": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1649419920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 BROADWAY",
            "address_2": "SUITE B-1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018193",
            "telephone_number": "239-939-2808",
            "fax_number": "239-939-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 BROADWAY",
            "address_2": "SUITE B-1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018193",
            "telephone_number": "239-939-2808",
            "fax_number": "239-939-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 7229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.