Provider Demographics
NPI:1659537488
Name:RADO, TEDDY (LCSW)
Entity type:Individual
Prefix:
First Name:TEDDY
Middle Name:
Last Name:RADO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 85TH ST
Mailing Address - Street 2:APT. 2O
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-3200
Mailing Address - Country:US
Mailing Address - Phone:718-898-6338
Mailing Address - Fax:
Practice Address - Street 1:394 HENDRIX ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-3611
Practice Address - Country:US
Practice Address - Phone:718-485-2100
Practice Address - Fax:718-485-2296
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032221-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical