Provider Demographics
NPI:1457926792
Name:KRISTEN RADLINSKI, LICSW LLC
Entity Type:Organization
Organization Name:KRISTEN RADLINSKI, LICSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:RADLINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-843-5549
Mailing Address - Street 1:16 SPRUCE ST # 2
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1904
Mailing Address - Country:US
Mailing Address - Phone:774-571-8611
Mailing Address - Fax:
Practice Address - Street 1:38 MONTVALE AVE STE 365
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2433
Practice Address - Country:US
Practice Address - Phone:617-843-5549
Practice Address - Fax:617-393-5749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty