Provider Demographics
NPI:1740768589
Name:REYNOLDS, PATRICIA JASMINE (LPC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JASMINE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:45875 BELL SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-8728
Mailing Address - Country:US
Mailing Address - Phone:234-254-5656
Mailing Address - Fax:234-254-5655
Practice Address - Street 1:15613 PINEVIEW DR STE C
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9096
Practice Address - Country:US
Practice Address - Phone:330-932-1594
Practice Address - Fax:330-368-0067
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YM0800X
OHC.2204521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health