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NPI Code Detail

MEDICARE: MS. ERIN TAYLOR REYNOLDS MA, LMHC

MEDICARE: MS. ERIN TAYLOR REYNOLDS MA, LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor39004529AIN

General Provider Information

NPI Number : 1003517368
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERIN TAYLOR REYNOLDS MA, LMHC
Provider Business Mailing Address
First Line : 3831 LAKE CLEARWATER PL APT 822
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46240-7739
Country : US
Telephone Number : 402-990-4129
Fax Number :
Provider Business Practice Location Address
First Line : 8606 ALLISONVILLE RD STE 120
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-3585
Country : US
Telephone Number : 402-990-4129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2023
Last Update Date : 01/08/2024

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