Provider Demographics
NPI:1376086579
Name:REINSEL, THOMAS (S3111)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:REINSEL
Suffix:
Gender:M
Credentials:S3111
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-1239
Mailing Address - Country:US
Mailing Address - Phone:419-549-8008
Mailing Address - Fax:419-223-0034
Practice Address - Street 1:517 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-1239
Practice Address - Country:US
Practice Address - Phone:419-549-8008
Practice Address - Fax:419-223-0034
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS3111104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker