Provider Demographics
NPI:1427159433
Name:RADA, CAROLEE VERDEUR (PSYD)
Entity type:Individual
Prefix:DR
First Name:CAROLEE
Middle Name:VERDEUR
Last Name:RADA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 HILL ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4318
Mailing Address - Country:US
Mailing Address - Phone:781-652-0336
Mailing Address - Fax:
Practice Address - Street 1:70 HILL STEET
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4318
Practice Address - Country:US
Practice Address - Phone:781-652-0336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8496171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor