Patrick Reynolds, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC19188 Issued in AZ

Practice address

459 N Gilbert Rd Ste C100
Gilbert, AZ 85234-4736

Phone

(480) 507-3644

NPI assigned

Dec 16, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• San Tan Behavioral Health Services

  • Child Mental Illness Respite Care
  • Gilbert, AZ
  • NPI 1770052292
  NPD (past)
• San Tan Behavioral Health Services LLC

  • Child Mental Illness Respite Care
  • Gilbert, AZ
  • NPI 1487123907
  NPD (past)

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1649939752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 N GILBERT RD STE C100",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852344736",
            "telephone_number": "480-734-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 N GILBERT RD STE C100",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852344736",
            "telephone_number": "480-507-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "PATRICK",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC19188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225206444",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruel Jaramillo Reyes, MD
• Debra Ann Reynolds
• James Reynolds, FNP-C
• Jenna Ann Reynolds, MS, BCBA
• Jennifer Nicole Reynolds
• Renae Belle Reynolds
• Taylor Reynolds, PA-C
• Wade Reynolds, FNP-C
• Lindsey L. Reynoso, LCSW, MSW, CCTP, BSP
• Philippe Y Reyns, MD

• Professional Counselor in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.