Active NPI
Kent Paul Radwani, LCSW
- Clinical Social Worker
- Providence Forge, VA
National Provider Identifier
1104902477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904002086
- Practice address
- 9403 Pocohontas Trail
Providence Forge, VA 23140 - Phone
- (804) 966-5959
- NPI assigned
- Oct 30, 2006
- Last updated
- Jun 23, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904002086 | VA | Primary |
Addresses
Primary practice location
9403 Pocohontas Trail
Providence Forge, VA 23140
Mailing address
10299 Woodman Rd
Glen Allen, VA 23060-4419
Phone (804) 727-8500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Catholic Charities | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Richmond, VA
- NPI 1376615005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245715200000",
"number": "1104902477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10299 WOODMAN RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230604419",
"telephone_number": "804-727-8500",
"fax_number": "804-727-8580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9403 POCOHONTAS TRAIL",
"city": "PROVIDENCE FORGE",
"state": "VA",
"postal_code": "23140",
"telephone_number": "804-966-5959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADWANI",
"first_name": "KENT",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-30",
"last_updated": "2009-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904002086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence Forge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.