Maureen Lyons Reardon, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3149 Issued in NC

Practice address

2500 Regency Parkway
Cary, NC 27518

Phone

(919) 800-1174

Fax

(919) 400-4535

NPI assigned

Jul 5, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

• Maureen Lyons Reardon, LLC

  dba M.L. Reardon, Ph.D., ABPP

  • Psychologist
  • Fayetteville, NC
  • NPI 1558810580
  Authorized official Same address or phone

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750733564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13200 STRICKLAND RD.",
            "address_2": "SUITE 114-331",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27613",
            "telephone_number": "919-800-1174",
            "fax_number": "919-400-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 REGENCY PARKWAY",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27518",
            "telephone_number": "919-800-1174",
            "fax_number": "919-400-4535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13200 Strickland Rd Ste 114-331",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276135212",
            "country_code": "US",
            "telephone_number": "919-800-1174",
            "fax_number": "919-400-4535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REARDON",
        "first_name": "MAUREEN",
        "middle_name": "LYONS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3149",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NC",
            "license": "3149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "19K0B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN TYPE II",
            "identifier": "1558810580",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Cary, NC
• Providers in Cary, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.