Provider Demographics
NPI:1811363823
Name:REYNOLDS, MARGARETMARY CLIGGETT (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARGARETMARY
Middle Name:CLIGGETT
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:MARY
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:2635 GLASCO TPKE
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498-1083
Mailing Address - Country:US
Mailing Address - Phone:646-322-9979
Mailing Address - Fax:845-679-0324
Practice Address - Street 1:15 PINE GROVE ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-1507
Practice Address - Country:US
Practice Address - Phone:646-322-9979
Practice Address - Fax:845-679-0324
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18-006734101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health