Provider Demographics
NPI:1952515454
Name:CARRADIN, DENNIS J (MED, LPCMH, BCETS)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:J
Last Name:CARRADIN
Suffix:
Gender:M
Credentials:MED, LPCMH, BCETS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 LIMESTONE RD
Mailing Address - Street 2:SUITE #109
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5536
Mailing Address - Country:US
Mailing Address - Phone:302-489-0220
Mailing Address - Fax:302-489-0223
Practice Address - Street 1:2055 LIMESTONE RD
Practice Address - Street 2:SUITE #109
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5536
Practice Address - Country:US
Practice Address - Phone:302-489-0220
Practice Address - Fax:302-489-0223
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000169101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health