Provider Demographics
NPI:1760435192
Name:REYNOLDS, ARTHUR RICHARD (MSW)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:RICHARD
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:16 W LONG ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2815
Mailing Address - Country:US
Mailing Address - Phone:614-225-0990
Mailing Address - Fax:
Practice Address - Street 1:16 W LONG ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2815
Practice Address - Country:US
Practice Address - Phone:614-225-0990
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00034931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical