Provider Demographics
NPI:1679659676
Name:REYNOLDS, HENRIETTA M (LPC)
Entity Type:Individual
Prefix:
First Name:HENRIETTA
Middle Name:M
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3184 BURNLEY PLACE
Mailing Address - Street 2:ALPHA THERAPEUTIC COUNSELING INC
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966
Mailing Address - Country:US
Mailing Address - Phone:215-504-9423
Mailing Address - Fax:215-504-1399
Practice Address - Street 1:3184 BURNLEY PLACE
Practice Address - Street 2:ALPHA THERAPEUTIC COUNSELING INC
Practice Address - City:HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:18966-2902
Practice Address - Country:US
Practice Address - Phone:215-504-9423
Practice Address - Fax:215-504-1399
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000973101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health