MEDICARE: MRS. ESTHER C REYNOLDS 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
1	101YP2500X	Professional Counselor	0701002219	VA
2	101YP2500X	Professional Counselor	3528	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972556959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ESTHER C REYNOLDS LPC

Provider Business Mailing Address
First Line	:	15 CLEVELAND AVE STE 2A
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-2937
Country	:	US
Telephone Number	:	276-666-0100
Fax Number	:	276-632-2797

Provider Business Practice Location Address
First Line	:	15 CLEVELAND AVE STE 2A
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-2937
Country	:	US
Telephone Number	:	276-666-0100
Fax Number	:	276-632-2797

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/15/2016

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