Provider Demographics
NPI:1700450848
Name:REARDON, CLAIRE LILLIAN (LCSW-C)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:LILLIAN
Last Name:REARDON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 GREENSPRING AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1353
Mailing Address - Country:US
Mailing Address - Phone:410-458-9109
Mailing Address - Fax:
Practice Address - Street 1:10015 OLD COLUMBIA RD STE B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1703
Practice Address - Country:US
Practice Address - Phone:443-766-9422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD287351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical