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General NPI Number Information
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NPI Number | 1164902888
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Entity Type | Individual
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Provider Name | JANINE FLANAGAN REARDON LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 71 MAIN ST STE 1300B
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City | TAUNTON
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State | MA
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Zip | 02780-2791
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Country | US
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Telephone | 774-406-0122
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Fax | 508-433-1871
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Provider Business Mailing Address
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Address Line | 16 HOWLAND RD
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City | BERKLEY
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State | MA
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Zip | 02779-1918
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Country | US
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Telephone | 774-406-0122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10461
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License Number State | MA
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