| Doctor Name: | MRS. RANDI JILL PADOVER-KIRSON |
| NPI Number: | 1225181258 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 0678811 |
| Business Practice Address: | 17 Flowerfield Suite 27 Saint James, NY - 117801500 |
| Business Phone Number: | 6319208500 |
| Business Fax Number: | |
| Mailing Address: | 51 Willow Ridge Dr, SMITHTOWN |
| State: | NY |
| Postal Code: | 117871572 |
| Phone Number: | 6319208500 |
| Fax Number: | |
| NPI Enumeration Date: | 01/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0678811 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |