Provider Demographics
NPI:1396883526
Name:BRODEY, Z RIKI (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:Z RIKI
Middle Name:
Last Name:BRODEY
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:ZELDA R
Other - Middle Name:
Other - Last Name:BRODEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:270 FARMINGTON AVENUE
Mailing Address - Street 2:SUITE 345
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032
Mailing Address - Country:US
Mailing Address - Phone:860-674-0665
Mailing Address - Fax:860-677-5412
Practice Address - Street 1:270 FARMINGTON AVENUE
Practice Address - Street 2:SUITE 345
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1909
Practice Address - Country:US
Practice Address - Phone:860-674-0665
Practice Address - Fax:860-677-5412
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT0013801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical