Provider Demographics
NPI:1427276195
Name:FITEK, RACEEL JARUDI
Entity type:Individual
Prefix:
First Name:RACEEL
Middle Name:JARUDI
Last Name:FITEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACEEL
Other - Middle Name:
Other - Last Name:JARUDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 HEARTHSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:266 MAIN ST
Practice Address - Street 2:BUILDING 3, SUITE 28B
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2018
Practice Address - Country:US
Practice Address - Phone:508-906-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA6144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health