Organization
JAMES P. REARDON
Active
Other names
COLUMBUS TRAUMATIC STRESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P. REARDON PH.D. (OWNER)
(614) 436-9985
Entity
Organization
Contact information
Practice address
7550 PINGUE DR, WORTHINGTON, OH 43085-1714
(614) 436-9985
Mailing address
200 BRADENTON AVE, DUBLIN, OH 43017-7515
(614) 793-1980
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2564
OH
103TC1900X
Counseling Psychologist
2564
OH
103TF0200X
Forensic Psychologist
2564
OH
103TR0400X
Rehabilitation Psychologist
2564
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0355459
—
OH
Enumeration date
09/21/2006
Last updated
06/30/2008
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