Healthcare Provider Details

I. General information

NPI: 1588653000
Provider Name (Legal Business Name): RODNEY LEE REINHARDT MA, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 MARBLE NE
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

835 CHUCKWAGON RD SE
RIO RANCHO NM
87124-3784
US

V. Phone/Fax

Practice location:
  • Phone: 505-839-8839
  • Fax: 505-839-8989
Mailing address:
  • Phone: 505-401-7944
  • Fax: 775-490-3434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0072641
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: