Provider Demographics
NPI:1639768351
Name:RADO, RAQUEL ERICA (LMSW)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:ERICA
Last Name:RADO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 GROVE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-5697
Mailing Address - Country:US
Mailing Address - Phone:786-288-6513
Mailing Address - Fax:
Practice Address - Street 1:294 GROVE ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-5697
Practice Address - Country:US
Practice Address - Phone:786-288-6513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111514104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker