Provider Demographics
NPI:1326188319
Name:REINHOLD, LEA NICOLE (LSW)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:NICOLE
Last Name:REINHOLD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MOUNT KEMBLE AVE
Mailing Address - Street 2:ATTN C LAMPRON
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5155
Mailing Address - Country:US
Mailing Address - Phone:973-971-4714
Mailing Address - Fax:973-290-7585
Practice Address - Street 1:100 MADISON AVENUE
Practice Address - Street 2:MMH CIS BOX 97
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07962-1956
Practice Address - Country:US
Practice Address - Phone:973-971-5402
Practice Address - Fax:973-971-5693
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05421800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker