MR. JACK EDWARD REYNOLDS (NPI# 1871818120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871818120 |
| Entity Type | Individual |
| Full Name | MR. JACK EDWARD REYNOLDS |
| Credential | LADC |
| Practice Address |
5604 Timber Ln Oklahoma City OK 73111-6877 |
| Practice Telephone | 4058167725 |
| Mailing Telephone | 4058167725 |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2010-03-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
OK | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942651880 | Jack Thomas Reynolds | Dentist | 4100 Ne Vivion Rd, Kansas City, MO 64119-2811 | 2016-06-22 |
| 1972852879 | Jack Reynolds | Licensed Vocational Nurse | 194 Via Baja, Ventura, CA 93003-1240 | 2012-09-06 |
| 1295825123 | Jack J. Reynolds Jr. | Dentist | 1002 Oak Dr, Richmond, IN 47374-1916 | 2006-10-13 |
| Street Address |
5604 TIMBER LN |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73111-6877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487947834 | Aletra Jamil Reynolds | Behavioral Analyst | 5604 Timber Ln, Oklahoma City, OK 73111-6877 | 2011-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689114779 | Brandi N Ridley | Counselor | 3621 N. Kelley Ave Ste. 100, Oklahoma City, OK 73111 | 2017-03-08 |
| 1790134708 | Raymond Arthur Smith Jr. | Counselor | 2329 Nw 111th, Oklahoma, OK 73111 | 2016-06-09 |
| 1124485263 | Oklahoma City County Health Department | Public Health or Welfare | 2700 Ne 63rd Street, Oklahoma City, OK 73111 | 2016-01-20 |
| 1528438710 | Brendel Lacey | Case Manager/Care Coordinator | 3017 N Martin Luther King Avenue, Oklahoma City, OK 73111 | 2015-09-30 |
| 1194108746 | Mary Margaret Mcmiller | Social Worker | 2700 Ne 63rd St, Oklahoma City, OK 73111 | 2015-07-01 |
| 1386037349 | Michelle Patrick | Counselor | 2525 Nw Expressway Suite 531, Building Up People Behavioral Health Service, Oklahoma, OK 73111 | 2015-03-13 |
| 1154764173 | Ne Wellness Community Health Clinic | Clinic/Center | 2600 Ne 63rd Street, Oklahoma City, OK 73111 | 2013-04-09 |
| 1033458070 | Mary Boyles | Case Manager/Care Coordinator | 1732 N Kelly, Oklahoma, OK 73111 | 2013-02-12 |
| 1427312164 | Sharonda Lavon Bowie | Counselor | 1328 Ne 53rd St, Oklahoma City, OK 73111 | 2012-06-27 |
| 1598029373 | Michael Brown | Counselor | 4413 Rock Island Circle, Oklahoma City, OK 73111 | 2012-06-27 |
| Find all providers in zip 73111 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639777410 | Larissa Wilson | Counselor | 9112 Rolling Green Ave, Oklahoma City, OK 73132-2055 | 2020-10-13 |
| 1497368179 | The Possibilities Place LLC | Counselor | 6900 Basswood Canyon Rd, Oklahoma City, OK 73162-7207 | 2020-08-24 |
| 1306457569 | Compassionate Hand Counseling Services Inc | Counselor | 1414 Sw 89th St Ste B, Oklahoma City, OK 73159-6312 | 2020-08-12 |
| 1942819081 | Michael Sylvester Radonski | Counselor | 14700 Rambling Creek Cir, Oklahoma City, OK 73142-9719 | 2020-07-24 |
| 1548895931 | Court Assistance Programs Inc. | Counselor | 600 N Dewey Avenue Suite 100, Oklahoma City, OK 73102 | 2020-03-06 |
| 1730713884 | Hanna Pauline Nassar | Counselor | 405 Nw 33rd St, Oklahoma City, OK 73118-8644 | 2020-02-27 |
| 1699319475 | Stephanie Gaynell Potts | Counselor | 1724 Ne 54th St, Oklahoma City, OK 73111-6832 | 2019-11-04 |
| 1962062471 | Babatunde Olumuyiwa Sosanya | Counselor | 1900 N Macarthur Blvd Ste 125, Oklahoma City, OK 73127-2650 | 2019-06-17 |
| 1598321440 | Tiba Counseling Center, Inc. | Counselor | 4301 Nw 63rd St Ste 305, Oklahoma City, OK 73116-1504 | 2019-05-16 |
| 1588132542 | Allison Martha Gibson | Counselor | 2525 Nw Expressway Ste 220, Oklahoma City, OK 73112-7227 | 2018-11-08 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73111 |
Please comment or provide details below to improve the information on MR. JACK EDWARD REYNOLDS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.