Individual provider Active NPI

Matthew Robert Radican, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1205711322
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110618 Issued in TX
Practice address
1341 W Mockingbird LN # 1242
Dallas, TX 75247-6913
Phone
(214) 456-2469
NPI assigned
Aug 7, 2025
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110618 TX Primary

Addresses

Primary practice location

1341 W Mockingbird LN # 1242
Dallas, TX 75247-6913

Mailing address

1341 W Mockingbird LN Ste 1242
Dallas, TX 75247-6913
Phone (214) 456-2469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260528001459 TX Practitioner - Clinical Social Worker 9436629748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1935 Medical District Dr
Dallas, TX 75235-7794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110618TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Challenge,Inc. PastSince Aug 10, 2025 Accepting new patients
Youth180, Inc. Rehabilitation, Substance Use Disorder PastSince Aug 10, 2025 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1205711322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 W MOCKINGBIRD LN STE 1242",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476913",
            "telephone_number": "214-456-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 W MOCKINGBIRD LN # 1242",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476913",
            "telephone_number": "214-456-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADICAN",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-07",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "110618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.