MEDICARE: ANDREA REINHARDT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	089.0135761TELE	VT
2	1041C0700X	Clinical Social Worker	44SC06055600	NJ
3	1041C0700X	Clinical Social Worker	14022	CT

General Provider Information

NPI Number	:	1518477561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA REINHARDT LCSW

Provider Business Mailing Address
First Line	:	26 TAUNTON LAKE DRIVE
Second Line	:
City	:	NEWTOWN
State	:	CT
Zip	:	06470
Country	:	US
Telephone Number	:	646-629-0929
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 TAUNTON LAKE DR
Second Line	:
City	:	NEWTOWN
State	:	CT
Zip	:	06470-1554
Country	:	US
Telephone Number	:	203-814-1702
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2017
Last Update Date	:	05/15/2024

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