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General NPI Number Information
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NPI Number | 1386954782
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Entity Type | Organization
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Legal Business Name | MICHAEL REITMAN, LCSW, LLC
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 1088 BLACK ROCK TPKE
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City | FAIRFIELD
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State | CT
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Zip | 06825-4107
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Country | US
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Telephone | 908-461-5311
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Fax | 203-365-0352
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Provider Business Mailing Address
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Address Line | 1088 BLACK ROCK TPKE
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City | FAIRFIELD
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State | CT
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Zip | 06825-4107
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Country | US
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Telephone | 908-461-5311
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Fax | 203-365-0352
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL N REITMAN
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Credential | LCSW, LADC
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Telephone | 908-461-5311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 006345
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License Number State | CT
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