Individual provider Active NPI

Patrina Lynn Reynolds

  • Addiction (Substance Use Disorder) Counselor
  • Shaker Heights, OH
National Provider Identifier
1750258596
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.191559 Issued in OH
Practice address
16100 Van Aken Blvd Apt 103
Shaker Heights, OH 44120-5302
Phone
(216) 391-6672
NPI assigned
Oct 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.191559 OH Primary

Addresses

Primary practice location

16100 Van Aken Blvd Apt 103
Shaker Heights, OH 44120-5302

Mailing address

16100 Van Aken Blvd Apt 103
Shaker Heights, OH 44120-5302
Phone (216) 391-6672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CDCA.191559OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1750258596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 VAN AKEN BLVD APT 103",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441205302",
            "telephone_number": "216-391-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 VAN AKEN BLVD APT 103",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441205302",
            "telephone_number": "216-391-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "PATRINA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.191559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.