Provider Demographics
NPI:1922553379
Name:WENDY S. RADDING, LCSW
Entity Type:Organization
Organization Name:WENDY S. RADDING, LCSW
Other - Org Name:HARMONY PSYCHOTHERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:SHEILA
Authorized Official - Last Name:RADDING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-583-7504
Mailing Address - Street 1:4000 GENESEE PL
Mailing Address - Street 2:SUITE 109
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-8302
Mailing Address - Country:US
Mailing Address - Phone:703-583-7504
Mailing Address - Fax:703-583-7507
Practice Address - Street 1:4000 GENESEE PL
Practice Address - Street 2:SUITE 109
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8302
Practice Address - Country:US
Practice Address - Phone:703-583-7504
Practice Address - Fax:703-583-7507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040046501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA923139271Medicaid
VA190001137Medicare PIN