Provider Demographics
NPI:1770181844
Name:REYNOLDS, ANNA ROSE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ROSE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 WOODOAK CIR
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE BEACH
Mailing Address - State:IL
Mailing Address - Zip Code:60073-4144
Mailing Address - Country:US
Mailing Address - Phone:262-612-5354
Mailing Address - Fax:
Practice Address - Street 1:2306 WOODOAK CIR
Practice Address - Street 2:
Practice Address - City:ROUND LAKE BEACH
Practice Address - State:IL
Practice Address - Zip Code:60073-4144
Practice Address - Country:US
Practice Address - Phone:262-612-5354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11415-1231041C0700X
IL149.0262711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical