Lynn M Reardon, LADC/MHC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

78 S Main St
Rutland, VT 05701-4594

Phone

(802) 775-2381

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rutland Mental Health Services, Inc.

  • Community/Behavioral Health Agency
  • Rutland, VT
  • NPI 1245127620
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1174600860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057020222",
            "telephone_number": "802-775-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 S MAIN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014594",
            "telephone_number": "802-775-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "LYNN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LADC/MHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "000303",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068-0000449",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007141",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "00048433",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsie Rae Rathbun, PTA
• Sydney M Rathbun
• Marty Ratner, DPT
• Ashleigh Raub
• Eileen Marie Reardon, LICSW
• Recovery House, Inc.
• Red Lotus Wellness Center LLC
• Suzanne Redden, MD
• Terri Lynn Redmond, FNP
• Regional Ambulance Service, Inc

• Community Health Worker in Rutland, VT
• Providers in Rutland, VT by specialty
• Community Health Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.