Provider Demographics
NPI:1063533313
Name:RADER, JOSEPH ALLEN (LSW)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ALLEN
Last Name:RADER
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MARTINEL DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4380
Mailing Address - Country:US
Mailing Address - Phone:330-673-6339
Mailing Address - Fax:300-673-6441
Practice Address - Street 1:275 MARTINEL DR
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4380
Practice Address - Country:US
Practice Address - Phone:330-673-6339
Practice Address - Fax:300-673-6441
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0600504104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker