Provider Demographics
NPI:1942407663
Name:MCREYNOLDS, NANCY JOAN (LCDC, LADC, LPC CAND)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JOAN
Last Name:MCREYNOLDS
Suffix:
Gender:F
Credentials:LCDC, LADC, LPC CAND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4436 N.W. 50TH
Mailing Address - Street 2:
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73112
Mailing Address - Country:US
Mailing Address - Phone:405-272-0660
Mailing Address - Fax:405-272-1596
Practice Address - Street 1:4436 NW 50TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2212
Practice Address - Country:US
Practice Address - Phone:405-272-0660
Practice Address - Fax:405-272-1596
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X
OKCANDIDATE101YP2500X
TX2544101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional