Provider Demographics
NPI:1992210249
Name:REYNOLDS-BATTRELL, SAMANTHA L (LPC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:L
Last Name:REYNOLDS-BATTRELL
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 1:2285 EDENDERRY DR
Mailing Address - Street 2:
Mailing Address - City:CRESCENT SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2174
Mailing Address - Country:US
Mailing Address - Phone:513-257-4964
Mailing Address - Fax:
Practice Address - Street 1:401 E MCMILLAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206
Practice Address - Country:US
Practice Address - Phone:513-221-3350
Practice Address - Fax:513-475-5673
Is Sole Proprietor?:No
Enumeration Date:2017-12-08
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1902035101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
N-A-1OtherLICENSURE