Provider Demographics
NPI:1922741347
Name:REDWAY, JULIAN (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:
Last Name:REDWAY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 WETHERSFIELD AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-1438
Mailing Address - Country:US
Mailing Address - Phone:860-236-4511
Mailing Address - Fax:860-231-8449
Practice Address - Street 1:331 WETHERSFIELD AVE STE 2
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-1438
Practice Address - Country:US
Practice Address - Phone:860-970-4451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006109104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker