Provider Demographics
NPI:1760625982
Name:RADLINSKI, KRISTEN KAY (LICSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:KAY
Last Name:RADLINSKI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:BROYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 LINCOLN ST
Mailing Address - Street 2:# 216
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3021
Mailing Address - Country:US
Mailing Address - Phone:774-571-8611
Mailing Address - Fax:
Practice Address - Street 1:7 LINCOLN ST
Practice Address - Street 2:309A
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3021
Practice Address - Country:US
Practice Address - Phone:774-571-8611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health