Reynolds, Donald

Reynolds, Donald is an sole proprietor health care provider with primary practice located at 20 Sherman Ave E , Fort Atkinson WI 53538-1864. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Reynolds, Donald can be contacted via phone (920) 728-1810.

Contact Information

Primary practice address
20 Sherman Ave E Fort Atkinson WI 53538-1864
Phone: (920) 728-1810
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 6746-125 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 6746125 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16206-132 Wisconsin

Profile Details

NPI number 1922591254
LBN Legal business name Reynolds, Donald
Credentials LPC. CSAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 12th, 2018
Last updated Mar 23rd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922591254 NPPES
Wisconsin MEDICAID 100078435

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