Reyna Nicole Witherspoon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

105500 Issued in TX

Practice address

3824 N University Dr
Nacogdoches, TX 75965-2011

Phone

(936) 558-6200

NPI assigned

Nov 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1700650942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652011",
            "telephone_number": "936-558-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652011",
            "telephone_number": "936-558-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3840 Hulen St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761077277",
            "country_code": "US",
            "telephone_number": "817-569-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "REYNA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "105500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Clyde Wilson, M.S., L.P.C.
• Joni M Wilson
• Melanie Lynn Wilson, RN, CNM
• Winnie-Stowell Hospital District (Stallings Court Nursing and Rehabilitation)
• Winnie-Stowell Hospital District (Willowbrook Nursing Center)
• Gregory Paul Wittpenn, M.D.
• Woden Isd
• Janae Kimberly Wojasinski, LPC
• Wallace D Womack, CRNA
• Emily Diana Woodruff, PTA

• Clinical Social Worker in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.