Healthcare Provider Details

I. General information

NPI: 1487309670
Provider Name (Legal Business Name): JENNIFER REYNOLDS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER SLOAN

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7426 US HIGHWAY 42 STE 106
FLORENCE KY
41042-2056
US

IV. Provider business mailing address

7426 US HIGHWAY 42 STE 106
FLORENCE KY
41042-2056
US

V. Phone/Fax

Practice location:
  • Phone: 859-282-0119
  • Fax: 859-282-8018
Mailing address:
  • Phone: 859-282-0119
  • Fax: 859-282-8018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: