Individual
MS. JOANNE TERESA RADWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.F.T.
Contact information
Practice address
430 NILES RD, NEW HARTFORD, CT 06057
(860) 738-3000
(860) 738-3000
Mailing address
PO BOX 561, NEW HARTFORD, CT 06057-0561
(860) 738-3000
(860) 738-3000
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000473
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000473
LICENSE NUMBER
CT
05
—
004195196
—
CT
01
—
186805
MHN PROVIDER ID
CT
01
—
207488
VALUE OPTIONS PRIVIDER ID
CT
01
—
410000473
BCBS PROVIDER ID
CT
Enumeration date
02/05/2007
Last updated
02/20/2023
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