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NPI Code Detail

MEDICARE: MS. BETTY J REYNOLDS LCSW

MEDICARE: MS. BETTY J REYNOLDS LCSW
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
11041C0700XClinical Social WorkerSW2625FL
21041C0700XClinical Social WorkerSW2625

General Provider Information

NPI Number : 1548481328
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BETTY J REYNOLDS LCSW
Provider Business Mailing Address
First Line : 2963 GULF TO BAY BLVD STE 320
Second Line :
City : CLEARWATER
State : FL
Zip : 33759-4286
Country : US
Telephone Number : 727-241-8800
Fax Number : 727-241-7050
Provider Business Practice Location Address
First Line : 2963 GULF TO BAY BLVD STE 320
Second Line :
City : CLEARWATER
State : FL
Zip : 33759-4286
Country : US
Telephone Number : 727-241-8800
Fax Number : 727-241-7050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 08/28/2024

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