Provider Demographics
NPI:1730310731
Name:REYNOLDS, LAURA R (LPC,LCPC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:R
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LPC,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4945 VISTA GREEN LN
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2893
Mailing Address - Country:US
Mailing Address - Phone:301-356-7033
Mailing Address - Fax:
Practice Address - Street 1:4945 VISTA GREEN LN
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2893
Practice Address - Country:US
Practice Address - Phone:301-356-7033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14050101YP2500X
MDLC3124101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional