Healthcare Provider Details

I. General information

NPI: 1982889937
Provider Name (Legal Business Name): JENNIFER SCHROEDER REYNOLDS EDS, LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CENTERVIEW DR UNIT 201
VESTAVIA HILLS AL
35216-3747
US

IV. Provider business mailing address

PO BOX 130461
BIRMINGHAM AL
35213-0461
US

V. Phone/Fax

Practice location:
  • Phone: 205-807-5372
  • Fax:
Mailing address:
  • Phone: 256-506-6982
  • Fax: 205-558-5513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2753
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: