Mistie McReynolds, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5194 Issued in KS

Practice address

1435 E Penrose LN
Olathe, KS 66062-1709

Phone

(913) 777-9093

NPI assigned

Jul 7, 2020

Sex

Female

Sole proprietor

Yes

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

Enrolled in KS

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Johnson County Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mission, KS
  • NPI 1174513444
  Medicare reassignment NPD
• Johnson County Mental Health Center

  • Community/Behavioral Health Agency
  • Mission, KS
  • NPI 1689324907
  NPD (past)

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1902424989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 E PENROSE LN",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621709",
            "telephone_number": "913-777-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 E PENROSE LN",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621709",
            "telephone_number": "913-777-9093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6440 Nieman Rd",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "KS",
            "postal_code": "662033326",
            "country_code": "US",
            "telephone_number": "913-826-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCREYNOLDS",
        "first_name": "MISTIE",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "5194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Ruppert McNeley-Phelps, LCP
• Cody J McNulty, DC
• Ronnie Tyson McQuay, LPC
• Brittney McQuown
• Lori Lucile McReynolds, LMSW
• Cheryle Marie McVey
• Carman Meade
• Stephanie Lynn Mealman, D.C.
• Joanna Claire Meats, O.D.
• Med-Care Medical Incorporated

• Clinical Social Worker in Olathe, KS
• Providers in Olathe, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.