MS. SUSAN J REARDON (NPI# 1164713855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164713855 |
| Entity Type | Individual |
| Full Name | MS. SUSAN J REARDON |
| Credential | MA, LMHC |
| Practice Address |
316 Dale St Waltham MA 02451-2955 |
| Practice Telephone | 7816427718 |
| Mailing Telephone | 7816427718 |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
3900 | MA | Behavioral Health & Social Service Providers |
| Street Address |
316 DALE ST |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-2955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851930499 | Nicole Mary Breen | Counselor | 375 Totten Pond Rd Ste 408, Waltham, MA 02451-2025 | 2019-12-30 |
| 1760957468 | Sherry Leigh Miller | Counselor | C/o Children's Charter, 77 Rumford Ave, Waltham, MA 02453 | 2018-10-09 |
| 1740786300 | Shannon Siska Stern | Counselor | 69 Hickory Dr Fl 3, Waltham, MA 02451-1011 | 2018-04-03 |
| 1174037998 | Kameron Mendes | Counselor | 60 Hope Ave Apt 121, Waltham, MA 02453-2749 | 2017-12-01 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1902236557 | Cailin Turcotte-good | Counselor | 2 Barnes St, Unit #1, Waltham, MA 02453-7002 | 2013-11-19 |
| 1205175957 | Kristen Pratt | Counselor | 284 Warren St, Waltham, MA 02453-7021 | 2013-01-31 |
| 1841563558 | Comprehensive Psychiatric Resources, Inc | Counselor | 203 Crescent St., Suite 110, Waltham, MA 02453 | 2012-02-13 |
| 1225358583 | Marilyn Raney | Counselor | 24 Chestnut St, Apt #1, Waltham, MA 02453-4477 | 2010-06-09 |
| 1891931010 | Michelle Lynn Felton | Counselor | 880 Main St, Waltham, MA 02451-8500 | 2008-12-17 |
| Find all providers in WALTHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.