Individual provider Active NPI

Michael Reynolds, LPC-MHSP

  • Mental Health Counselor
  • Manchester, TN
National Provider Identifier
1871621649
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2764 Issued in TN
Practice address
3388 McMinnville Hwy
Manchester, TN 37355-3624
Phone
(931) 499-3113
Fax
(931) 499-3113
NPI assigned
Mar 1, 2007
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X 2764 TN Primary
Professional Counselor 101YP2500X 2764 TN

Addresses

Primary practice location

3388 McMinnville Hwy
Manchester, TN 37355-3624

Mailing address

PO Box 1004
Manchester, TN 37349-1004

Other identifiers 1

IdentifierTypeStateIssuer
2764OtherTNBOARD FOR LICENSED PROFESSIONAL COUNSELORS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250612000441 TN Practitioner - Mental Health Counselor 4981114576 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2764TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Reynolds Counseling & Consulting PLLC Addiction (Substance Use Disorder) CurrentSince May 8, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1871621649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1004",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373491004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3388 MCMINNVILLE HWY",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553624",
            "telephone_number": "931-499-3113",
            "fax_number": "931-499-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MICHAEL",
        "credential": "LPC-MHSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "2764",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "2764",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD FOR LICENSED PROFESSIONAL COUNSELORS",
            "identifier": "2764",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, TN

Sources for this page

Verify at the official NPI Registry.