Provider Demographics
NPI:1083292767
Name:NADINE PADOWICZ
Entity Type:Organization
Organization Name:NADINE PADOWICZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PADOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-980-5460
Mailing Address - Street 1:34 ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-7103
Mailing Address - Country:US
Mailing Address - Phone:203-980-5460
Mailing Address - Fax:
Practice Address - Street 1:540 TUNXIS HILL RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-4412
Practice Address - Country:US
Practice Address - Phone:203-980-5460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1841491420Medicaid
CT1841491420OtherCIGNA