Organization
LISA JOAN REARDON LICSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JOAN REARDON LICSW (PSYCHOTHERAPIST)
(202) 526-4445
Entity
Organization
Contact information
Practice address
1325 QUINCY ST NE, WASHINGTON, DC 20017-2615
(202) 526-4445
(202) 526-7401
Mailing address
1325 QUINCY ST NE, WASHINGTON, DC 20017-2615
(202) 526-4445
(202) 526-7401
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
LC301995
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116815
KAISER PERMANENTE
DC
01
—
6510-0001
BLUECROSS BLUESHIELD
DC
Enumeration date
03/06/2009
Last updated
11/15/2011
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