Provider Demographics
NPI:1306029145
Name:RADA, STELLA (MS, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:
Last Name:RADA
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19420 SW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5809
Mailing Address - Country:US
Mailing Address - Phone:305-801-7232
Mailing Address - Fax:
Practice Address - Street 1:2645 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 140
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3624
Practice Address - Country:US
Practice Address - Phone:305-801-7232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-16
Last Update Date:2007-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7484102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst