Provider Demographics
NPI:1407857899
Name:RADE, TAMMY LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LEE
Last Name:RADE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:LEE
Other - Last Name:BENJAMIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:228 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18504
Mailing Address - Country:US
Mailing Address - Phone:570-904-7363
Mailing Address - Fax:570-348-4079
Practice Address - Street 1:254 DALEVILLE HIGHWAY
Practice Address - Street 2:
Practice Address - City:COVINGTON TWP
Practice Address - State:PA
Practice Address - Zip Code:18444-7831
Practice Address - Country:US
Practice Address - Phone:570-904-7363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical