Provider Demographics
NPI:1639249386
Name:MCNALLY-REYNOLDS, ANN F (LCSWC)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:F
Last Name:MCNALLY-REYNOLDS
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON GROVE
Mailing Address - State:MD
Mailing Address - Zip Code:20880
Mailing Address - Country:US
Mailing Address - Phone:301-258-5028
Mailing Address - Fax:
Practice Address - Street 1:8620 OAK MONT ST
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877
Practice Address - Country:US
Practice Address - Phone:301-258-5028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD064021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
096232OtherMAGELLAN BEHAVIORAL HEALT
1727OtherBLUE CROSS NATL CPTL ARPA
S04956Medicare UPIN
096232OtherMAGELLAN BEHAVIORAL HEALT