Provider Demographics
NPI:1548311285
Name:MCREYNOLDS, VICKI LEE (LMFT)
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:LEE
Last Name:MCREYNOLDS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 QUAIL CT
Mailing Address - Street 2:SUITE 211
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8701
Mailing Address - Country:US
Mailing Address - Phone:925-631-1299
Mailing Address - Fax:925-631-1261
Practice Address - Street 1:43 QUAIL CT
Practice Address - Street 2:SUITE 211
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8701
Practice Address - Country:US
Practice Address - Phone:925-631-1299
Practice Address - Fax:925-631-1261
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 35770101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health