Provider Demographics
NPI:1093773483
Name:RADDING, WENDY SHEILA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:SHEILA
Last Name:RADDING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 GENESEE PL
Mailing Address - Street 2:SUITE 109
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-8302
Mailing Address - Country:US
Mailing Address - Phone:703-583-7504
Mailing Address - Fax:703-583-7507
Practice Address - Street 1:4000 GENESEE PL
Practice Address - Street 2:SUITE 109
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8302
Practice Address - Country:US
Practice Address - Phone:703-583-7504
Practice Address - Fax:703-583-7507
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040046501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical