Reynolds, Lisa Denise

Reynolds, Lisa Denise is an individual health care provider with primary practice located at 1100 Grampian Blvd , Williamsport PA 17701-1907. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Reynolds, Lisa Denise can be contacted via phone (570) 320-7525.

Contact Information

Primary practice address
1100 Grampian Blvd Williamsport PA 17701-1907
Phone: (570) 320-7525
Fax: (570) 320-7484
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X CW012595 Pennsylvania

Profile Details

NPI number 1952300568
LBN Legal business name Reynolds, Lisa Denise
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2005
Last updated Feb 1st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952300568 NPPES
Pennsylvania MEDICAID 0018788340002

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