Phillip Anthony Reynolds

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14543 Issued in MD

Practice address

8120 Woodmont Ave Ste 205
Bethesda, MD 20814-2784

Phone

(202) 906-9588

Fax

(202) 403-3200

NPI assigned

May 7, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1649835406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BRONCO CT",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208746159",
            "telephone_number": "301-325-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 WOODMONT AVE STE 205",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142784",
            "telephone_number": "202-906-9588",
            "fax_number": "202-403-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "PHILLIP",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "preynolds@copiouslife.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8120 Woodmont Ave Ste 205",
            "city": "Bethesda",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208142784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vicki Estefani Reyes Hernandez
• Frank Paul Reynolds, M.D.
• James Carter Reynolds, MD
• Michael J Reynolds, MD
• Morgan Reynolds, DO
• Sarah Morgan Reynolds, M.D.
• Reza Ghorbani MD PC
• Nadereh Rezaeieh Azadi
• Omeed Adam Rezaie Tirabadi, DDS
• Kathryn Daly Rheem, M.S., LGMFT

• Clinical Social Worker in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.