Provider Demographics
NPI:1598312829
Name:REINHOLD, ADDELINE
Entity Type:Individual
Prefix:
First Name:ADDELINE
Middle Name:
Last Name:REINHOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HOLIDAY DR APT A
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-8311
Mailing Address - Country:US
Mailing Address - Phone:603-918-4437
Mailing Address - Fax:
Practice Address - Street 1:303 BELMONT ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-4311
Practice Address - Country:US
Practice Address - Phone:603-263-6456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0216101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)