| Radzom Counseling Llc | |
|
40b Edwardsville Prof Park Edwardsville IL 62025-3602 | |
| (618) 248-2040 | |
| (618) 248-2040 |
| Full Name | Radzom Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 40b Edwardsville Prof Park, Edwardsville, Illinois |
| Authorized Official Name and Position | Brian C Radzom (OWNER) |
| Authorized Official Contact | 6182482040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radzom Counseling Llc Po Box 101 Edwardsville IL 62025-0101 Ph: (618) 248-2040 | Radzom Counseling Llc 40b Edwardsville Prof Park Edwardsville IL 62025-3602 Ph: (618) 248-2040 |
| NPI Number | 1639462948 |
|---|---|
| Provider Enumeration Date | 05/18/2011 |
| Last Update Date | 10/24/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639462948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149012706 (Illinois) | Primary |
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