Healthcare Provider Details

I. General information

NPI: 1922457092
Provider Name (Legal Business Name): CHRISTINA REYNOLDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA MEAGHER

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 LYNNFIELD ST
LYNN MA
01904-1419
US

IV. Provider business mailing address

20 WOODLAND S
LYNN MA
01904-1404
US

V. Phone/Fax

Practice location:
  • Phone: 860-922-4195
  • Fax:
Mailing address:
  • Phone: 860-922-4195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number120017
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: