Pamela K Reynolds, CADC III CC5G
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Lacrosse, WI
NPI 1720028640 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1720028640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 1305 (WI)
- Practice address
- 1005 Jackson Street
Lacrosse, WI 54601 - Phone
- (608) 791-6147
- Fax
- (608) 791-9511
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1305 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1305 | WI | Yes |
Addresses
Primary practice location
1005 Jackson Street
Lacrosse, WI 54601
Mailing address
700 West Avenue South
Attn Physician Services
Lacrosse, WI 54601
Phone (608) 791-4156
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39365500 | Medicaid | WI |
Other providers in Lacrosse, WI
- Doreen M Olson
- Cynthia Lee Patterson-Rhorer
- Susan S Quinn
- Heather S Rabe
- Red Feather Therapy and Consulting, LLC
- Patricia Burg Richgels
- Kathleen E Roberts
- Jack W Schermerhorn
- Leon George Schlesser
- Becky M Schmitz
All providers in Lacrosse, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.