Individual provider Active NPI

Madeleine Reynolds, M.S., LMHC, NCC

  • Mental Health Counselor
  • Rochester, NY
National Provider Identifier
1952553646
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
004144-1 Issued in NY
Practice address
46 Prince St
Suite Ll004
Rochester, NY 14607-1023
Phone
(585) 507-0454
Fax
(585) 461-3439
NPI assigned
Oct 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 004144 NY
Mental Health Counselor 101YM0800X 14175 NC
Mental Health Counselor 101YM0800X 004144-1 NY Primary

Addresses

Primary practice location

46 Prince St
Suite Ll004
Rochester, NY 14607-1023

Mailing address

410 E Renovah Cir
Wilmington, NC 28403-1228
Phone (585) 586-8433

Other practice location 1

202 S 5th Ave Ste C
Wilmington, NC 28401-5495
Phone (585) 586-8433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20240403002485 NY Practitioner - Mental Health Counselor 9638517162 Practice locations: Rochester, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14175NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1952553646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E RENOVAH CIR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031228",
            "telephone_number": "585-586-8433",
            "fax_number": "585-461-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 PRINCE ST",
            "address_2": "SUITE LL004",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071023",
            "telephone_number": "585-507-0454",
            "fax_number": "585-461-3439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 S 5th Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284015495",
            "country_code": "US",
            "telephone_number": "585-586-8433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MADELEINE",
        "name_prefix": "Ms.",
        "credential": "M.S., LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004144",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14175",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004144-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.