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NPI Code Detail

MEDICARE: JENNA L REYNOLDS MA, NCC, LPC

MEDICARE: JENNA L REYNOLDS MA, NCC, LPC
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
1101YP2500XProfessional Counselor98290TX
2101YP2500XProfessional Counselor0701010775VA

General Provider Information

NPI Number : 1679230569
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA L REYNOLDS MA, NCC, LPC
Provider Business Mailing Address
First Line : 780 LYNNHAVEN PKWY STE 400
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23452-7332
Country : US
Telephone Number : 571-207-6246
Fax Number : 571-376-6605
Provider Business Practice Location Address
First Line : 10710 MIDLOTHIAN TPKE STE 127
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23235-4776
Country : US
Telephone Number : 804-207-6737
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2021
Last Update Date : 10/29/2025

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