Kenneth Reddan, LCSW
Social Worker, Clinical in Staten Island, NY. Individual provider (NPI-1).
NPI number1063502425
StatusActive
Last updated in NPPESOct 29, 2020
Details
- NPI
- 1063502425
- Entity type
- Individual (NPI-1)
- Name
- Kenneth Reddan
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 13, 2006
- Certification date
- Oct 29, 2020
- Last updated
- Oct 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 071025-1 | NY | Yes |
Practice location
20 Giordan CtStaten Island, NY 10303-2538
Phone 718-871-4593 · Fax 718-228-3905
Mailing address
7304 5th AveBrooklyn, NY 11209-2604
Phone 718-871-4593 · Fax 718-871-4593
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