Provider Demographics
NPI:1003984600
Name:REYNOLDS, SHEILA (LPC)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:EDMOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:2121 A BELLEVUE RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021
Mailing Address - Country:US
Mailing Address - Phone:478-272-1190
Mailing Address - Fax:478-275-6509
Practice Address - Street 1:1528 TELFAIR ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3908
Practice Address - Country:US
Practice Address - Phone:478-304-1244
Practice Address - Fax:478-304-1254
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003781101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional