Provider Demographics
NPI:1053491522
Name:RADDING, RINA (MSW)
Entity type:Individual
Prefix:MRS
First Name:RINA
Middle Name:
Last Name:RADDING
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-2481
Mailing Address - Country:US
Mailing Address - Phone:781-784-5778
Mailing Address - Fax:
Practice Address - Street 1:27 GLEN ST
Practice Address - Street 2:SUITE 14
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-2481
Practice Address - Country:US
Practice Address - Phone:781-784-5778
Practice Address - Fax:781-341-0420
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1012901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA476470000OtherMAGELLAN
MAPO1210Medicare ID - Type Unspecified