Provider Demographics
NPI:1790556660
Name:THE RAEDA GROUP, PLLC
Entity Type:Organization
Organization Name:THE RAEDA GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DELICIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-364-8882
Mailing Address - Street 1:500 W 6TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2854
Mailing Address - Country:US
Mailing Address - Phone:512-364-8882
Mailing Address - Fax:
Practice Address - Street 1:500 W 6TH ST STE 400
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2854
Practice Address - Country:US
Practice Address - Phone:512-364-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)