Provider Demographics
NPI:1952431025
Name:WOODS, RENDA L (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RENDA
Middle Name:L
Last Name:WOODS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4270 MAIN ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-2306
Mailing Address - Country:US
Mailing Address - Phone:203-372-6516
Mailing Address - Fax:203-372-6516
Practice Address - Street 1:4270 MAIN ST
Practice Address - Street 2:SUITE 206
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-2306
Practice Address - Country:US
Practice Address - Phone:203-372-6516
Practice Address - Fax:203-372-6516
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0021581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical