Provider Demographics
NPI:1750457883
Name:HADIS, RENATA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RENATA
Middle Name:
Last Name:HADIS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MRS
Other - First Name:RENATA
Other - Middle Name:KESTELBOIM
Other - Last Name:HADIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:600 UPPER MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1623
Mailing Address - Country:US
Mailing Address - Phone:973-746-8029
Mailing Address - Fax:973-746-1483
Practice Address - Street 1:600 UPPER MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1623
Practice Address - Country:US
Practice Address - Phone:973-746-8029
Practice Address - Fax:973-746-1483
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC006677001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical