MRS. LISA REYNOLDS (NPI# 1952728370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952728370 |
| Entity Type | Individual |
| Full Name | MRS. LISA REYNOLDS |
| Credential | CASAC |
| Practice Address |
3251 Route 112 Bldg 9 Suite 2 Medford NY 11763-1446 |
| Mailing Address |
977 N Ocean Ave Patchogue NY 11772-1106 |
| Practice Telephone | 6314516007 |
| Practice Fax Number | 6312978121 |
| Mailing Telephone | 6314516007 |
| Mailing Fax Number | 6312978121 |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2014-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
22297 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104379262 | Lisa Reynolds | Occupational Therapist | 702 Nw 17th Pl, Cape Coral, FL 33993-6801 | 2016-07-25 |
| 1447550504 | Lisa Reynolds | Speech-Language Pathologist | 2 Grant St, Potsdam, NY 13676-2310 | 2010-10-23 |
| 1942528799 | Lisa Reynolds | Licensed Practical Nurse | 466 S Columbus Ave, Mount Vernon, NY 10553-1917 | 2010-05-04 |
| 1649473018 | Lisa Reynolds | Marriage & Family Therapist | 157 Kent Road, Warren, CT 06754-1804 | 2007-06-06 |
| 1598836918 | Lisa A. Reynolds | Physical Therapist | 3188 Siler Cty Snow Cp Rd, Siler City, NC 27344-7232 | 2006-11-10 |
| 1215996277 | Lisa Dawn Reynolds | Nurse Practitioner | 410 Maple Ave West, Ste 5, Vienna, VA 22180 | 2006-03-20 |
| 1265030688 | Lisa Reynolds | Occupational Therapist | 24310 W 109th Ter, Olathe, KS 66061-8852 | 2020-10-16 |
| 1205468766 | Lisa A Reynolds | Specialist | 22 North St, Jaffrey, NH 03452-5340 | 2020-02-12 |
| 1376990358 | Lisa Reynolds | Counselor | 3600 Jerome Ave, Bronx, NY 10467-1052 | 2016-05-19 |
| 1861882292 | Lisa Reynolds | Counselor | 20399 Route 19, Suite 110, Cranberry Township, PA 16066-6134 | 2015-01-23 |
| Street Address |
3251 ROUTE 112 BLDG 9 SUITE 2 |
| City | MEDFORD |
| State | NY |
| Zip Code | 11763-1446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437276789 | Joanna E Kelly | Social Worker | 3251 Route 112, Building #9, Suite 2, Medford, NY 11763-1446 | 2007-03-23 |
| 1013446806 | Emily Klein | Social Worker | 3251 Route 112, Medford, NY 11763-1446 | 2017-06-06 |
| 1518419761 | Diana Simonelli | Social Worker | 3251 Route 112, Building 9 Suite 2, Medford, NY 11763-1446 | 2016-11-03 |
| 1386193639 | Cabrina Marie Riggio | Counselor | 3251 Route 112, Bldg 9, Suite 2, Medford, NY 11763-1446 | 2016-09-28 |
| 1497109441 | Saima Sattar Khusbu | Social Worker | 3251 Route 112, Building 9, Suite 2, Medford, NY 11763-1446 | 2016-04-15 |
| 1659735496 | Danielle Stewart | Social Worker | 3251 Route 112, Building 9 Suite 2, Medford, NY 11763-1446 | 2016-04-07 |
| 1427426253 | Brandon Tosov | Counselor | 3251 Route 112, Bldg 9 Ste 2, Medford, NY 11763-1446 | 2015-09-10 |
| 1811311988 | Jeanne Capriola | Counselor | 3251 Route 112, Bldg. 9, Suite 2, Medford, NY 11763-1446 | 2014-02-10 |
| 1417371766 | Helen Simon | Counselor | 3251 Route 112, Building 9, Suite 2, Medford, NY 11763-1446 | 2014-02-06 |
| 1205259868 | Christopher Mattimore | Counselor | 3251 Route 112, Bldg. 9, Ste. 2, Medford, NY 11763-1446 | 2014-01-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316572027 | Rebecca Molino | Specialist | 9, 3251 Ny-112 #2, Medford, NY 11763 | 2020-03-03 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1265917041 | Bay Taxi Inc | Taxi | 36/94 Horseblock Rd, Medford, NY 11763 | 2018-09-27 |
| 1184108383 | Bay Taxi Inc | Taxi | 36/94 Horsblock Road, Medford, NY 11763 | 2018-09-24 |
| 1215419650 | Megan Bell | Speech-Language Pathologist | 135 Buffalo Avenue, Medford, NY 11763 | 2018-09-01 |
| 1922592906 | Elizabeth L Oakley | Specialist | 1 Sprat St, Medford, NY 11763 | 2018-06-21 |
| 1609383389 | Federation of Organizations for The New York State Mentally Disabled | Clinic/Center | 3390 Route 112 Ste B, Medford, NY 11763 | 2018-01-04 |
| 1497109607 | Tabitha Aitken | Massage Therapist | 28 Masem Ct, Medford, NY 11763 | 2016-04-14 |
| 1518326685 | Betty Velez | Specialist | 21 Red Pine Rd, Medford, NY 11763 | 2016-02-18 |
| 1134527054 | Angelo L D'esposito | Social Worker | 77 Robinson Ave, Medford, NY 11763 | 2014-12-09 |
| Find all providers in zip 11763 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124685870 | Tracy L Sunde | Counselor | 512 4th St Sw, Medford, MN 55049-9568 | 2019-05-28 |
| 1245737956 | Larkspur Counseling LLC | Counselor | 328 S Central Ave Ste 212, Medford, OR 97501-7274 | 2018-04-09 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1255875654 | Danielle E Peterson | Counselor | 429 W Broadway Ave, Medford, WI 54451-1608 | 2016-12-05 |
| 1376099523 | Patricia Mcatee | Counselor | 243 N Holly St, Apt 1, Medford, OR 97501-5603 | 2016-08-28 |
| 1437512449 | Sage Bosch | Counselor | 1003 E Main St # 104, Medford, OR 97504-7448 | 2016-03-29 |
| 1114385853 | April Collins-macauley | Counselor | 234 W 5th St, Medford, OR 97501-2611 | 2016-02-09 |
| 1154714418 | Marykay Powell | Counselor | 4175 Cedar Ln, Medford, OR 97501-9611 | 2015-03-11 |
| 1699163931 | Violeta Iguchi | Counselor | 3501 Excel Dr Ste 225, Medford, OR 97504-8067 | 2015-01-08 |
| 1790109049 | Ellen Lynch | Counselor | 3251 Route 112 Ste 2, Medford, NY 11763-1446 | 2014-02-06 |
| Find all providers in MEDFORD | ||||
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| 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.