NPIMap

Organization Active NPI

Radzom Counseling LLC

  • Clinical Social Worker
  • Edwardsville, IL
National Provider Identifier
1639462948
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012706 Issued in IL
Legal business name
RADZOM COUNSELING LLC
Practice address
40B Edwardsville Prof Park
Edwardsville, IL 62025-3602
Phone
(618) 248-2040
Fax
(618) 248-2040
NPI assigned
May 18, 2011
Last updated
Oct 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Authorized official

Name
Brian C Radzom, LCSWNPI 1790941300
Title
Owner
Phone
(618) 248-2040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149012706 IL Primary

Addresses

Primary practice location

40B Edwardsville Prof Park
Edwardsville, IL 62025-3602

Mailing address

PO Box 101
Edwardsville, IL 62025-0101
Phone (618) 248-2040

National Provider Directory

National Provider Directory

Locations

1946 Edwardsville Club Plaza Ct
Edwardsville, IL 62025
Phone (618) 248-2040

40 Edwardsville Prof Park
Edwardsville, IL 62025
Phone (618) 248-2040

40 Edwardsville Prof Park
#B
Edwardsville, IL 62025
Phone (618) 248-2040

40B Edwardsville Prof Park
Edwardsville, IL 62025
Phone (618) 248-2040

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1639462948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620250101",
            "telephone_number": "618-248-2040",
            "fax_number": "618-248-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40B EDWARDSVILLE PROF PARK",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253602",
            "telephone_number": "618-248-2040",
            "fax_number": "618-248-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADZOM COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-18",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "RADZOM",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-248-2040",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.