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General NPI Number Information
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NPI Number | 1639768351
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Entity Type | Individual
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Provider Name | RAQUEL ERICA RADO LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/16/2021
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 10321 NORTHERN BLVD
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City | CORONA
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State | NY
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Zip | 11368-1136
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Country | US
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Telephone | 786-288-6513
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Fax |
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Provider Business Mailing Address
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Address Line | 2180 38TH ST APT D5
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City | ASTORIA
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State | NY
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Zip | 11105-1820
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Country | US
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Telephone | 786-288-6513
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 097599
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License Number State | NY
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