Grace Reynolds

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC.0016965 Issued in CO

Practice address

2305 Canyon Blvd Ste 101
Boulder, CO 80302-5651

Phone

(720) 370-6465

NPI assigned

Nov 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1542326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1699244806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 CANYON BLVD STE 101",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025651",
            "telephone_number": "720-370-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 CANYON BLVD STE 101",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025651",
            "telephone_number": "720-370-6465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 Dixon Ave",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800268879",
            "country_code": "US",
            "telephone_number": "303-443-8500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2935 Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803032366",
            "country_code": "US",
            "telephone_number": "720-370-6465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-16",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0016965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revamped by Nutrition
• Kirsten Anne Revitte
• Revo Physiotherapy and Sports Performance
• Taylor Revoal
• Bryan J Reynolds, M.D.
• Robert James Reynolds Jr.
• Shawn Michael Reynolds, MA, LPC, CAC III
• Masoud Rezaei
• Helen Rho
• Kathryn Lorette Rhoades, PH.D., LP

• Mental Health Counselor in Boulder, CO
• Providers in Boulder, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.