James P. Reardon

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2564 Issued in OH

Legal business name

JAMES P. REARDON

Doing business as

Columbus Traumatic Stress Center

Practice address

7550 Pingue Dr
Worthington, OH 43085-1714

Phone

(614) 436-9985

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

James P. Reardon, PH.D.NPI 1861436750

Title

Owner

Phone

(614) 436-9985

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• COLUMBUS TRAUMATIC STRESS CENTER Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James P. Reardon, PH.D.

  • Counseling Psychologist
  • Columbus, OH
  • NPI 1861436750
  NPD (past) Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1184722126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BRADENTON AVE",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177515",
            "telephone_number": "614-793-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 PINGUE DR",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430851714",
            "telephone_number": "614-436-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES P. REARDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "REARDON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-436-9985",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "2564",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "2564",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": "OH",
            "license": "2564",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": "OH",
            "license": "2564",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0355459",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLUMBUS TRAUMATIC STRESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychologist in Worthington, OH
• Providers in Worthington, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.