Healthcare Provider Details

I. General information

NPI: 1982949418
Provider Name (Legal Business Name): JOANNE REINHARDT, LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2012
Last Update Date: 12/27/2019
Certification Date: 12/27/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GLOVER AVE STE 10
NORWALK CT
06850-1395
US

IV. Provider business mailing address

150 GLOVER AVE APT 447
NORWALK CT
06850-4505
US

V. Phone/Fax

Practice location:
  • Phone: 203-722-6365
  • Fax:
Mailing address:
  • Phone: 203-722-6365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number001552
License Number StateCT

VIII. Authorized Official

Name: JOANNE REINHARDT
Title or Position: PROVIDER
Credential:
Phone: 203-722-6365