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General NPI Number Information
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NPI Number | 1619096120
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Entity Type | Organization
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Legal Business Name | ESTHER WOLF RADIN, CSW, PC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 291 WALL ST
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City | KINGSTON
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State | NY
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Zip | 12401-3849
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Country | US
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Telephone | 845-255-2965
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Fax | 845-255-2965
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Provider Business Mailing Address
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Address Line | 291 WALL ST
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City | KINGSTON
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State | NY
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Zip | 12401-3849
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Country | US
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Telephone | 845-255-2965
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Fax | 845-255-2965
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MS. ESTHER WOLF RADIN
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Credential | LCSW, BCD
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Telephone | 845-255-2965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PR0136891
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License Number State | NY
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