Provider Demographics
NPI:1437743606
Name:REARDON, ROBERT MICHAEL JR (BCBA, CADC-I)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:REARDON
Suffix:JR
Gender:M
Credentials:BCBA, CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E LONG ST STE 201
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-3106
Mailing Address - Country:US
Mailing Address - Phone:775-461-0999
Mailing Address - Fax:
Practice Address - Street 1:900 E LONG ST STE 201
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3106
Practice Address - Country:US
Practice Address - Phone:775-461-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV08121-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)