Mr Gregory Homan Reynolds, LICSW, LADC is a medicare enrolled "Social Worker - Clinical" provider in Saint Paul, Minnesota. His current practice location is
451 Lexington Pkwy N, Saint Paul, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(651) 280-2310.
Mr Gregory Homan Reynolds is licensed to practice in Minnesota (license number 28771) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1760750921.
Healthcare Provider's Profile
| Full Name | Mr Gregory Homan Reynolds |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 451 Lexington Pkwy N, Saint Paul, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1760750921
- Provider Enumeration Date: 12/02/2011
- Last Update Date: 01/13/2021
Medicare PECOS Information:
- PECOS PAC ID: 6507151560
- Enrollment ID: I20210128001706
Medical Identifiers
Medical identifiers for Mr Gregory Homan Reynolds such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1760750921 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 24431 (New York) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 301886 (Minnesota) | Secondary |
| 1041C0700X | Social Worker - Clinical | 28771 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Gregory Homan Reynolds allows following entities to bill medicare on his behalf.
| Entity Name | Lyn-lake Psychotherapy And Wellness Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609355163
PECOS PAC ID: 9638581291
Enrollment ID: O20201224000071 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Gregory Homan Reynolds is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mr Gregory Homan Reynolds, LICSW, LADC
451 Lexington Pkwy N,
Saint Paul, MN 55104-4636
Ph: (651) 280-2310 | Mr Gregory Homan Reynolds, LICSW, LADC
451 Lexington Pkwy N,
Saint Paul, MN 55104-4636
Ph: (651) 280-2310 |
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