Provider Demographics
NPI:1104171032
Name:REITMAN, BARBARA A (LISW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:REITMAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 BROCKTON CIR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-2201
Mailing Address - Country:US
Mailing Address - Phone:440-234-8351
Mailing Address - Fax:
Practice Address - Street 1:26777 LORAIN ROAD
Practice Address - Street 2:#308
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3225
Practice Address - Country:US
Practice Address - Phone:440-716-2222
Practice Address - Fax:440-716-1954
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 1101251101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health