Active NPI
Reen Hayes Lyddane, LPC & LMFT
- Professional Counselor
- Vienna, VA
National Provider Identifier
1437407343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701002421
- Practice address
- 2110 A Gallows Road
Vienna, VA 22182 - Phone
- (703) 864-8371
- NPI assigned
- Aug 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701002421 | VA | Primary |
| Marriage & Family Therapist | 106H00000X | 0717700777 |
Addresses
Primary practice location
2110 A Gallows Road
Vienna, VA 22182
Mailing address
8204 Galahad Court
Annandale, VA 22003
Phone (703) 864-8371
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701002421 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346025600000",
"number": "1437407343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8204 GALAHAD COURT",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "22003",
"telephone_number": "703-864-8371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 A GALLOWS ROAD",
"city": "VIENNA",
"state": "VA",
"postal_code": "22182",
"telephone_number": "703-864-8371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYDDANE",
"first_name": "REEN",
"middle_name": "HAYES",
"name_prefix": "Ms.",
"credential": "LPC & LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-27",
"last_updated": "2012-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701002421",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": "0717700777",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.