Healthcare Provider Details

I. General information

NPI: 1457790271
Provider Name (Legal Business Name): PATRICIA REYNOLDS LAADC, LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA ANN REYNOLDS-MEADE LAADC

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 DUCKER RD
ARDEN NC
28704-8484
US

IV. Provider business mailing address

33 DUCKER RD
ARDEN NC
28704-8484
US

V. Phone/Fax

Practice location:
  • Phone: 828-373-7140
  • Fax:
Mailing address:
  • Phone: 828-373-7140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number29626
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: