Individual provider Active NPI

Kayleen Reardon

  • Mental Health Counselor
  • Portsmouth, NH
National Provider Identifier
1487202297
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1145 Sagamore Ave
Portsmouth, NH 03801-5585
Phone
(603) 431-6703
Fax
(603) 430-3753
NPI assigned
Aug 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1145 Sagamore Ave
Portsmouth, NH 03801-5585

Mailing address

1145 Sagamore Ave
Portsmouth, NH 03801-5585
Phone (603) 431-6703

Other identifiers 1

IdentifierTypeStateIssuer
3078870MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241128000000 CO Practitioner - Mental Health Counselor 4587199591 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Behavioral Care, Inc. Professional CurrentSince Nov 1, 2024 Accepting new patients
Seacoast Mental Health Center, Inc. PastSince Sep 1, 2019 Accepting new patients

Locations

950 Wadsworth Blvd
Ste 202
Lakewood, CO 80214
Phone (303) 257-7047

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1487202297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 SAGAMORE AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015585",
            "telephone_number": "603-431-6703",
            "fax_number": "603-430-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 SAGAMORE AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015585",
            "telephone_number": "603-431-6703",
            "fax_number": "603-430-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "KAYLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078870",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.