Provider Demographics
NPI:1982889937
Name:REYNOLDS, JENNIFER SCHROEDER (EDS, LPC-S)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SCHROEDER
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:EDS, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130461
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-0461
Mailing Address - Country:US
Mailing Address - Phone:256-506-6982
Mailing Address - Fax:205-558-5513
Practice Address - Street 1:100 CENTERVIEW DR UNIT 201
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-3747
Practice Address - Country:US
Practice Address - Phone:205-807-5372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2753101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51546000OtherBCBS