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General NPI Number Information
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NPI Number | 1184091365
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Entity Type | Individual
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Provider Name | SHIQUITA NICHOLE REDDICK LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 655 BROADWAY
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City | PATERSON
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State | NJ
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Zip | 07514-1923
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Country | US
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Telephone | 973-523-0089
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Fax | 973-523-5022
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Provider Business Mailing Address
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Address Line | 1028 CHATEAU CROSSING DR APT 103
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City | FORT MILL
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State | SC
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Zip | 29715-8485
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Country | US
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Telephone | 973-280-7722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL05727500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P014784
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC06424000
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C017282
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License Number State | NC
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