Provider Demographics
NPI:1639566672
Name:REARDON, SUSAN WESTFALL (LMHC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:WESTFALL
Last Name:REARDON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:WESTFALL
Other - Last Name:KLAUBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:3 BROOK LN
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MA
Mailing Address - Zip Code:01503-1671
Mailing Address - Country:US
Mailing Address - Phone:617-416-2172
Mailing Address - Fax:
Practice Address - Street 1:3 BROOK LN
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MA
Practice Address - Zip Code:01503-1671
Practice Address - Country:US
Practice Address - Phone:617-416-2172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5967101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health