MARY REARDON (NPI# 1073964219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073964219 |
| Entity Type | Individual |
| Full Name | MARY REARDON |
| Credential | LPC |
| Practice Address |
544 Main St Bay St Louis MS 39520-2730 |
| Mailing Address |
10850 Ala Moana St Diamondhead MS 39525-4504 |
| Practice Telephone | 2284603242 |
| Mailing Telephone | 2284603242 |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2019-12-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2082 | MS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00018213 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 Broad Ave, Gulfport, MS 395013603 | 2288631132 | 2288651700 |
| 544 Main St, Bay St Louis, MS 395202730 | 2284603242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336579440 | Mary Reardon | Physical Therapist | 533 S York St, Elmhurst, IL 60126-3951 | 2013-11-26 |
| 1851663264 | Mary Reardon | Registered Nurse | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2012-01-31 |
| 1417956731 | Mary Clare Reardon | Specialist | 2529 Glenn Hendren Dr, Suite 200, Liberty, MO 64068-9625 | 2005-07-19 |
| Street Address |
544 MAIN ST |
| City | BAY ST LOUIS |
| State | MS |
| Zip Code | 39520-2730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470568 | Michael Stephens | Student in an Organized Health Care Education/Training Program | 236 Eighth Street, Bay Saint Louis, MS 39520 | 2020-09-06 |
| 1437400959 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 600 Pine St., Bay St Louis, MS 39520 | 2012-09-24 |
| 1245581768 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 602 Pine St., Bay St Louis, MS 39520 | 2012-09-24 |
| 1912258427 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 6590 Lakeshore Road, Bay St Louis, MS 39520 | 2012-09-24 |
| 1942551445 | Hancock Medical Health Services | Nurse Practitioner | 750 Blue Meadow Road, Bay St Louis, MS 39520 | 2012-09-24 |
| 1134404809 | Hancock Chiropractic LLC | Chiropractor | 806 Hwy 90, Bay St. Louis, MS 39520 | 2011-10-13 |
| 1669762902 | Stacey Marie Kreher | Nurse Practitioner | 1009 Benigno Ln., Hancock Women's Center, Bay St. Louis, MS 39520 | 2011-04-07 |
| 1639352123 | Joyce Deloris Buie | Nurse Practitioner | 3062 Longfellow Rd, #25, Bay St. Louis, MS 39520 | 2007-12-07 |
| 1336346451 | Ochsner Medical Center - Hancock LLC | Clinic/Center | 3068 Port and Harbor Dr, Bay St Louis, MS 39520 | 2007-07-02 |
| 1043437684 | The Beach Surgical Group | Clinic/Center | 952 Green Meadow Rd., Bay St Louis, MS 39520 | 2007-04-18 |
| Find all providers in zip 39520 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750478 | Latibbie Cavett | Counselor | 1311 Rosemont Dr, Clinton, MS 39056-3954 | 2020-11-05 |
| 1306445309 | Teresa Nicole Worthy | Counselor | 6690 Rose Ln # B, Marion, MS 39342-9201 | 2020-10-21 |
| 1841899978 | Kbccms, LLC | Counselor | 1501 Jackson Ave W Ste 113, Oxford, MS 38655-2566 | 2020-10-20 |
| 1053910281 | Julie Magee Powell | Counselor | 121 Sweetgum Rd N, Brandon, MS 39047-6235 | 2020-10-19 |
| 1245838143 | Liria Peshkepia | Counselor | 1105 W Jackson St, Tupelo, MS 38804-2515 | 2020-10-13 |
| 1346847837 | Connection Counseling | Counselor | 336 N Green St, Tupelo, MS 38804-3828 | 2020-10-07 |
| 1609480086 | Robin Melissa Aucoin | Counselor | 1745 County Road 344, Quitman, MS 39355-9454 | 2020-09-03 |
| 1619589538 | Pamela Peoples | Counselor | 1888 Main St Ste C-189, Madison, MS 39110-6337 | 2020-08-21 |
| 1194334656 | Shania Barr | Counselor | 33 Bedford Forrest Ln, Hattiesburg, MS 39401-9186 | 2020-07-29 |
| 1609485515 | Charleen Brown Sproles | Counselor | 434 Katherine Dr Ste B, Flowood, MS 39232-8811 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
| City | BAY ST LOUIS |
| Zip Code | 39520 |
Please comment or provide details below to improve the information on MARY REARDON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.