Active NPI
Faith Reynolds
- Counselor
- Boys Town, NE
National Provider Identifier
1720473721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 12547
- Practice address
- 13460 Walsh Dr
Boys Town, NE 68010-7529 - Phone
- (531) 355-3362
- Fax
- (531) 355-3375
- NPI assigned
- Apr 6, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Counselor | 101Y00000X | 12547 | NE | Primary |
Addresses
Primary practice location
13460 Walsh Dr
Boys Town, NE 68010-7529
Mailing address
13460 Walsh Dr
Boys Town, NE 68010-7529
Phone (531) 355-3362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 28, 2025 through Apr 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12547 | NE | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Psychiatric Partners, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Chicago, IL
- NPI 1982873766
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1720473721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13460 WALSH DR",
"city": "BOYS TOWN",
"state": "NE",
"postal_code": "680107529",
"telephone_number": "531-355-3362",
"fax_number": "531-355-3375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13460 WALSH DR",
"city": "BOYS TOWN",
"state": "NE",
"postal_code": "680107529",
"telephone_number": "531-355-3362",
"fax_number": "531-355-3375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "FAITH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NE",
"license": "12547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boys Town, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.