Stephen M Reynolds, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L8546 Issued in OR

Practice address

10260 SW Greenburg Rd Ste 400
Portland, OR 97223-5514

Phone

(646) 960-3553

NPI assigned

Apr 14, 2021

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

• Corvallis Internal Medicine, PC

  • Internal Medicine Physician
  • Corvallis, OR
  • NPI 1710172622
  NPD

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1982284725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6298 SW GRAND OAKS DR APT F202",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10260 SW GREENBURG RD STE 400",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235514",
            "telephone_number": "646-960-3553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6298 SW Grand Oaks Dr Apt F202",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973334773",
            "country_code": "US",
            "telephone_number": "917-319-6371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-14",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L8546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Rudd Reynolds
• Nancy Louise Reynolds, LCSW,RN
• Olivia Reynolds, PSY.D.
• Ricco Cory Reynolds, FNP-C
• Sharon Elizabeth Reynolds, MN, FNP
• Olivia Brooks Reynoldson, LAC, DAOM
• Chelsea Reynosa
• Carlos Reynoso
• Giselle Reynoso
• Shiva Rezaei

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.